The Arc of North Carolina Policy Blog

NCGA Update HB 344

2011-06-08T05:53:00.002-04:00

Late last evening HB 344: Tax Credit for Children with Disabilities passed the House with a vote of 73 in favor to 39 opposed. This bill will now go to the Senate.

NCGA News: House Bill 344 Tax Credits for Children with Disabilites on House Floor Tonight.

2011-06-07T20:16:00.003-04:00

HB 344: Tax Credit Bill for Children with Disabilities will be voted on this evening by the NC House. Herre is what the bill does:
1. Provide up to a 6,000 dollar tax credit for children with disabilities that are either enrolled in private school or home school. To qualify a student must have an active IEP and receive daily special education services. The student also must be enrolled in a public school for two semesters with that active IEP.

2. The bill establishes a Special Needs Trust Fund, that will be used at the discretion of the State Board of Education to provide supplemental services and supports for students with disabilities that remain in the public school system.

The Arc of NC has been working on this legislation for several sessions.

NCGA: Senate Will Release Budget Today

2011-05-24T05:43:00.002-04:00

The NC Senate will release its budget proposal today. It cuts 500 million more than what was included in the governor's budget and from all reports will have significant differences from the House budget.

The Senate Health and Human Services Appropriation Committee will meet this morning at 8:30AM in room 643 of the Legislative Office Building. The full Senate appropriation committee is scheduled to meet on Wednesday.

The budget is expected to head back to the House by next week. There will then be a conference committee to work out differences before sending it to the governor.

Of interest to our community will be if there are any significant cuts to Medicaid optional services and how much of a cut there will be to provider rates. We will report here once we have seen the proposal.

Bill Update: Senate Bill 465 Behavioral Health Management

2011-05-04T09:33:00.002-04:00

Today the Senate Mental Health committee will take up Senator Fletcher Hartsell's Behavioral Health Management bill. This proposed legislation would permit new 1915 (b)(c) waiver sites to incorporate under a hospital statute instead of the current 122C state statute. A major concern of advocates is that this might permit the new waiver sites to not have CFACs and will remove oversight from the department. We will have more information regarding this bill later today.

Here is the bill:
SB 465 Behavioral Health Management

NCGA News: Senate Budget Targets

2011-05-03T16:45:00.001-04:00

Word spread like wildfire today that the Senate budget targets will be substantially lower than the House targets. Looks like the Senate is looking to cut an additional 70 million out of the HHS budget. We will be following this closely.

NCGA News: The House Debates the Budget on the Floor

2011-05-03T16:37:00.002-04:00

Today's marathon session of the House is all about the budget. Overall, the health and human services budget writers in the House were careful to use a scalpel not a hatchet when trying to address budget cuts. For example, they did not eliminate any optional services in Medicaid. They did however give them a bit of a trim.

Another example is in state funded community services, they did a 20 million dollar cut but only for one year of the two year budget. There are of course another round of inflationary freezes to Medicaid provider rates and a 2% cut to provider rates, except for physician rates.

The Education budget is a bit of a different tale. K-12 education received a 8.5% cut and the elimination of teacher assistances in grades K-3 seems to be a given. There are also deep cuts in community college and university funding. We will be watching to see what happens as the budget vote wraps up tonight in the House.

So here is a round up of the special provisions that we were most interested in:

This special provisions puts for two cuts. The fist is a 20 million dollar cut in state funds and the second is a swap of funding at LMEs. A damaging special provision that would not have permitted LME’s to use state funds for individuals who have a Medicaid card was eliminated. This specific special provision would have disproportionately affected people with developmental disabilities.

MH/DD/SAS COMMUNITY SERVICE FUNDS
SECTION 10.11.(a) The Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (as used in this section "The Division") is directed to reduce the Community Service Fund by twenty million dollars ($20,000,000).
SECTION 10.11.(b) The Division is directed, through consultation with LME
representatives and stakeholders, to develop a set of standardized covered benefits for recipients of LME Service Funds that shall become the only services paid for by community service funds through LMEs. These services shall be best practices for developmental disabilities, mental illness, and substance abuse.
SECTION 10.11.(c) Effective January 1 2012, the Division shall implement a
co-payment for all mental health, developmental disabilities, and substance abuse services based upon the Medicaid co-payment rates.
SECTION 10.11.(d) The Division is directed to reduce the Community Service Fund by twenty-five million dollars ($25,000,000) for the 2011-2012 fiscal year based on available fund balance reported by the LMEs' 2010 fiscal audit. The Division is directed to allocate the reduction among LMEs based on unreserved, undesignated fund balance totals, as of June 30, 2010. The LMEs are required to backfill the reduction with fund balance availability and not further reduce services beyond the amount identified in subsection (a) of this section.
SECTION 10.11.(e) LMEs are directed to spend their unreserved, undesignated fund balance on services, commensurate with the reduction directed by the Division. Quarterly reports shall be submitted to the Division by LMEs to ensure expenditures from fund balance occurs at the level required by this law. Additionally, the Division shall review the designation of reserved or designated fund balance accounts to determine whether accounts may be moved to unreserved, undesignated, in essence increasing the unreserved, undesignated fund balance available for purchase of services. If categories of funds are moved into the unreserved/undesignated categories, the affected LMEs are encouraged to spend these funds to minimize their share of the twenty million dollars ($20,000,000) in reductions to services as required in subsection (a) of this section.
SECTION 10.11.(f) The Department of Health and Human Services shall report to the House and Senate Appropriations Subcommittees by December 12, 2011, on the status of implementing this section.

Medicaid and Mental Health, Developmental Disabilities and Substance Abuse Services Provisions:
The following two provisions detail the provider rate changes in the House budget. The first provision states that there will not be an inflationary rate increase for Medicaid provider rates. The second provision states that the rate adjustment will be 2% for this biennial. It also sets up a carve out for physicians so that they will not be impacted by the rate reductions.
NO INFLATIONARY MEDICAID PROVIDER RATE INCREASES
SECTION 10.43. Notwithstanding any other provision of law, the Secretary of the Department of Health and Human Services shall not authorize any inflationary increases to Medicaid provider rates during the 2011-2013 fiscal biennium, except that inflationary increases for healthcare providers paying provider fees may occur if the State share of the
increases can be funded with provider fees.

MEDICAID PROVIDER RATE ADJUSTMENTS
SECTION 10.46.(a) Subject to the limitations contained in Section 10.37(a)(6) a. and b. of this act, the Secretary of Health and Human Services shall reduce Medicaid provider rates for all Medicaid providers by two percent (2%) except as follows:
(1) Physician Services. – The provider rate for physicians shall not be reduced.
General Assembly Of North Carolina Session 2011
(2) Hospital Inpatient Services. – The provider rate for inpatient hospital
services shall be reduced by a percentage equal to two percent (2%) plus a
percentage sufficient to achieve the amount of savings that would have
resulted if provider rates for physicians had been reduced by two percent
(2%). The provider rate for inpatient hospital services shall be further
reduced to offset any reduction or inflationary freeze attributable to
outpatient hospital services or to critical access hospitals.
SECTION 10.46.(b) The rate reductions required by this section shall take effect in accordance with the following schedule:
(1) October 1, 2011. – The provider rate reductions required by subsection (a) of this section shall take effect no later than October 1, 2011. If effective after
July 1, 2011, the reductions shall be adjusted by a percentage sufficient to
yield savings as if the reductions had taken effect on July 1, 2011.
(2) July 1, 2012. – On July 1, 2012, the provider rate reductions required by
subsection (a) of this section shall be adjusted to the level at which they
would have been without the adjustment required by subdivision (1) of this
subsection.
SECTION 10.46.(c) No other adjustments to the provider rates for hospital
outpatient or critical access hospital rates shall be made, except that hospital outpatient and critical access hospital rates may continue to be eligible for inflationary increases.

In each budget we see a provision that details the Mental Health Changes for the coming two fiscal years. This one details the issues with cash flow problems for many non-single stream LMEs and also details the funding for local inpatient psychiatric beds.

MENTAL HEALTH CHANGES
SECTION 10.8.(a) For the purpose of mitigating cash flow problems that many non-single-stream local management entities (LMEs) experience at the beginning of each fiscal year, the Department of Health and Human Services, Division of Mental Health,
Developmental Disabilities, and Substance Abuse Services, shall adjust the timing and method by which allocations of service dollars are distributed to each non-single-stream LME. To this end, the allocations shall be adjusted such that at the beginning of the fiscal year the Department shall distribute not less than one-twelfth of the LME's continuation allocation and subtract the amount of the adjusted distribution from the LME's total reimbursements for the fiscal year.
SECTION 10.8.(b) Of the funds appropriated in this act to the Department of
Health and Human Services, Division of Mental Health, Developmental Disabilities, and
Substance Abuse Services, the sum of twenty-nine million one hundred twenty-one thousand six hundred forty-four dollars ($29,121,644) for the 2011-2012 fiscal year and the sum of twenty-nine million one hundred twenty-one thousand six hundred forty-four dollars ($29,121,644) for the 2012-2013 fiscal year shall be allocated for the purchase of local inpatient psychiatric beds or bed days. In addition, at the discretion of the Secretary of Health and Human Services, existing funds allocated to LMEs for community-based mental health, developmental disabilities, and substance abuse services may be used to purchase additional local inpatient psychiatric beds or bed days. These beds or bed days shall be distributed across the State in LME catchment areas and according to need as determined by the Department. The Department shall enter into contracts with the LMEs and community hospitals for the management of these beds or bed days. The Department shall work to ensure that these contracts are awarded equitably around all regions of the State. Local inpatient psychiatric beds or bed days shall be managed and controlled by the LME, including the determination of which local or State hospital the individual should be admitted to pursuant to an involuntary commitment order. Funds shall not be allocated to LMEs but shall be held in a statewide reserve at the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services to pay for services authorized by the LMEs and billed by the hospitals through the LMEs. LMEs shall remit claims for payment to the Division within 15 working days of receipt of a clean claim from the hospital and shall pay the hospital within 30 working days of receipt of payment from the Division. If the Department determines (i) that an LME is not effectively managing the beds or bed days for which it has responsibility, as evidenced by beds or bed days in the local hospital not being utilized while demand for services at the State psychiatric hospitals has not reduced, or (ii) the LME has failed to comply with the prompt payment provisions of this subsection, the Department may contract with another LME to manage the beds or bed days, or, notwithstanding any other provision of law to the contrary, may pay the hospital directly. The Department shall develop reporting requirements for LMEs regarding the utilization of the beds or bed days. Funds appropriated in this section for the purchase of local inpatient psychiatric beds or bed days shall be used to purchase additional beds or bed days not currently funded by or through LMEs and shall not be used to supplant other funds available or otherwise appropriated for the purchase of psychiatric inpatient services under contract with community hospitals, including beds or bed days being purchased through Hospital Utilization Pilot funds appropriated in S.L. 2007-323. Not later than March 1, 2012, the Department shall report to the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, and the Fiscal Research Division on a uniform system for beds or bed days purchased (i) with local funds, (ii) from existing State appropriations, (iii) under the Hospital Utilization Pilot, and (iv) purchased using funds appropriated under this subsection.
SECTION 10.8.(c) Of the funds appropriated in this act to the Department of
Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, for mobile crisis teams, the sum of five million seven hundred thousand dollars ($5,700,000) shall be distributed to LMEs to support 30 mobile crisis teams.
The new mobile crisis units shall be distributed over the State according to need as determined by the Department.
SECTION 10.8.(d) The Department of Health and Human Services may create a midyear process by which it can reallocate State service dollars away from LMEs that do not appear to be on track to spend the LMEs' full appropriation and toward LMEs that appear able to spend the additional funds.

The following special provision continues the transition of utilization management to LMEs.

TRANSITION OF UTILIZATION MANAGEMENT OF COMMUNITY-BASED SERVICES TO LOCAL MANAGEMENT ENTITIES
SECTION 10.13. The Department of Health and Human Services shall collaborate with LMEs to enhance their administrative capabilities to assume utilization management responsibilities for the provision of community-based mental health, developmental disabilities, and substance abuse services. The Department may, with approval of the Office of State Budget and Management, use funds available to implement this section.

This year’s budget had multiple cuts to services and funding. The following special provision details the $5 million dollar cut to nonprofit organizations receiving funding from the Department of Health and Human Services. There is a carve out for state funding to nonprofit organization to pay for direct services to individuals with developmental disabilities.

REDUCE FUNDING FOR NONPROFIT ORGANIZATIONS
SECTION 10.18. For fiscal years 2011-2012 and 2012-2013, the Department of Health and Human Services shall reduce the amount of funds allocated to nonprofit General Assembly Of North Carolina Session 2011 organizations by five million dollars ($5,000,000) on a recurring basis. In achieving the reductions required by this section, the Department (i) shall minimize reductions to funds allocated to nonprofit organizations for the provision of direct services and (ii) shall not reduce funds allocated to nonprofit organizations to pay for direct services to individuals with developmental disabilities.

The Division of HHS and Division of DMA are in the process of applying for a 1915 (i) state plan amendment to plan for the provision of services for people living in assisted living centers and receiving personal care services.

MEDICAID WAIVER FOR ASSISTED LIVING
SECTION 10.38.(a) The Department of Health and Human Services, Division of Medical Assistance (Division), shall develop and implement a home- and community-based services program under Medicaid State Plan 1915(i) authority in order to continue Medicaid funding of personal care services to individuals living in adult care homes.
SECTION 10.38.(b) The Division shall implement the program upon approval of the application by the Centers for Medicare and Medicaid Services.
SECTION 10.38.(c) On or before April 1, 2012, the Division shall provide a report on the status of approval and implementation of the program to the Joint Legislative Commission on Governmental Operations, 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.

Once again there was a special provision detailing the co-pay for the CAP MR/DD program recipients. This provision has been included in the previous two budgets.
FAMILIES PAY PART OF THE COST OF SERVICES UNDER THE CAP-MR/DD PROGRAM AND THE CAP-CHILDREN'S PROGRAM BASED ON FAMILY INCOME
SECTION 10.36.(a) Subject to approval from the Centers for Medicare and
Medicaid Services (CMS), the Department of Health and Human Services, Division of Medical Assistance, shall, in consultation with the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services and Community Alternatives Program (CAP) stakeholders, develop a schedule of cost-sharing requirements for families of children with incomes above the Medicaid allowable limit to share in the costs of their child's Medicaid expenses under the CAP-MR/DD (Community Alternatives Program for Mental Retardation and Developmentally Disabled) and the CAP-C (Community Alternatives Program for General Assembly Of North Carolina Session 2011 Children). The cost-sharing amounts shall be based on a sliding scale of family income and shall take into account the impact on families with more than one child in the CAP programs.
In developing the schedule, the Department shall also take into consideration how other states have implemented cost-sharing in their CAP programs. The Division of Medical Assistance may establish monthly deductibles as a means of implementing this cost-sharing. The Department shall provide for at least one public hearing and other opportunities for individuals to comment on the imposition of cost-sharing under the CAP program schedule.
SECTION 10.36.(b) The Division of Medical Assistance shall also, in
collaboration with the Controller's Office of the Department of Health and Human Services, the Division of Information Resource Management (DIRM), and the new vendor of the replacement Medicaid Management Information System, develop business rules, program policies, and procedures and define relevant technical requirements.
SECTION 10.36.(c) Implementation of this provision shall be delayed until the implementation of the new Medicaid Management Information System.

Education Budget:
The education budget remained fairly unchanged during the amendment process with the exception of a special provision amendment sponsored by Representative Rick Glazier (D-Cumberland) that protected funding for positive behavioral support programs in our state.
SECTION 7.19.(c) In implementing budget reductions under this act, the
Department of Public Instruction shall make no reduction in funding or positions for the Positive Behavioral Support program.

The cuts that affect K-3rd grade teaching assistants in our public schools was not changed during the amendment process.
Included in the budget is a special provision detailing funds for children with disabilities receiving services in our public schools.
FUNDS FOR CHILDREN WITH DISABILITIES
SECTION 7.2. The State Board of Education shall allocate additional funds for
children with disabilities on the basis of three thousand five hundred ninety-eight dollars and fifty-five cents ($3,598.55) per child. Each local school administrative unit shall receive funds for the lesser of (i) all children who are identified as children with disabilities or (ii) twelve and five-tenths percent (12.5%) of its 2011-2012 allocated average daily membership in the local school administrative unit. The dollar amounts allocated under this section for children with disabilities shall also adjust in accordance with legislative salary increments, retirement rate adjustments, and health benefit adjustments for personnel who serve children with disabilities.

Breaking News: Budget Will Come Out Today

2011-04-12T14:14:00.002-04:00

We have received word that the budget in the House will roll out between 4:00-5:00pm.

Action Alert: Take Action on Managed Care Waivers Today

2011-03-29T18:52:00.002-04:00

Issue

The NC General Assembly and the State DHHS are developing a plan to require all developmental disability services to be managed with mental illness and substance abuse services in a managed care system. The Arc, along with almost every other developmental disability related organization, opposes this move. Services and support for people with developmental disabilities are life long and do not fit in the medical model of managed care.

Last year, we worked with the DHHS and General Assembly to develop a plan allowing the managed care model to expand to two LME's if the state would work with advocates and other stakeholders to study the effect of such a system and to review other possibilities. Now the Council of Community Programs and the DHHS are lobbying the legislature to remove these provisions. They are pushing a plan to allow three LME's to immediately bid to manage over one half of the counties in North Carolina. This plan is being touted as a cost saving measure, but there are more effective and efficient methods to manage the developmental disability system.

We just learned a few hours ago that DHHS will issue a Request for Application today or tomorrow allowing for statewide expansion of the managed care waiver by 2014.

Basically, the focus has become rapid expansion of Managed Care at the expense of positive outcomes for people with developmental disabilities.

The Arc is working with Legislators. We are asking to be involved in plan development and requesting the opportunity to present options that are best suited to manage the developmental disability system. We need your help now!

Please call your legislator with this simple message...

*Please do not place the DD system into a managed care system with mental illness and substance abuse services.

*Bring DD advocates, providers, families and consumers to the table to help design a system that works

*Review proposals by The Arc and others concerning the 1915i option and DD system design.

If legislators ask you for additional information please refer them to our website and tell them we will deliver a packet of information to them and are available for questions.

Find your state legislator here

NC Legislative Building Phone # (919) 733 7926

Quick Bill Update: Juror Qualifications

2011-03-23T17:18:00.002-04:00

HB 234: Juror Qualifications/Disabilities was on the calendar yesterday for third reading. There was a debate about the age section of the bill. There was no more debate regarding the rights of people who are deaf or hard of hearing to serve. The final vote was 106 in favor to 12 opposed.

The bill will now go to the Senate. Senator Clodfelter and Senator Brunstetter will lead the bill through the committee and floor debate.

Monday Hot Topics: Coming This Week in the NC General Assembly

2011-03-21T17:01:00.004-04:00

This week the House and Senate Appropriation Subcommittee on Health and Human Services will continue to hear presentations on key budget topics. On the agenda for Tuesday is Health Choice and on Wednesday there will be a presentation of possible consolidation options.

A few key bills will see action this week. On the House floor HB 234: Juror Qualifications/Disabilities will get a third reading and final vote before heading to the Senate. We will be following the floor debate regarding this bill. We expect to see at least one amendment that will only affect the ability for a person over the age of 66 to request a deferment of jury duty.

In the Senate Mental Health and Youth Services, members will be presented SB 316: Add'l Section 1915 Medicaid Waiver Sites-(Sponsor: Senator Fletcher Hartsell). This is the bill that will remove the current restrictions on expansion of the 1915 b/c waiver sites that was placed in special provisions during the previous budget cycle.

We are also waiting on more details regarding the projected revenue picture. Under the Blog-N&O blog had a recent post that stated that the state tax revenue was above the projections but non tax revenue was bellow projections. How these numbers shake out is important as we near subcommittee budget presentations. On that topic, House Education Subcommittee has stated there will be no additional meetings for presentations to the committee. The members of this appropriation subcommittee are beginning to create what will become their budget.

Read the report:General Fund-March Report: Fiscal Research Division.

NCGA Update: Bill Vote Information

2011-03-17T19:32:00.003-04:00

Today the House took up HB 234: Juror Qualifications/Disabilities. This bill was hotly debated, similar to last years debate. Although this bill simply brings our state statute in line with federal law, it became increasingly clear that several members of the House did not feel that people who are deaf or hard of hearing should be jurors. The bill sponsors Representatives Rick Glazier, Sarah Stevens, and Ruth Samuelson presented excellent arguments to counter the points brought up by opposition, including that our current statute is illegal, that deaf people are currently serving as jurors and that the AOC requested this change. The bill received a vote of 94 in favor and 24 opposed. There was an objection to third reading. This bill will be back on the calendar for Monday.

In the Senate there was a vote taken on Senate Bill 248: Update Archaic Disability Terms. This bill was presented yesterday in Senate Health by its sponsor Senator Fletcher Hartsell. The bill comes out of the General Statutes Commission and updates existing statutes to People First Language. The bill had a single amendment presented by Senator Fletcher Hartsell to fix a additional term. The bill received unanimous support and will now go to the House.

NCGA Update: Two Bills of Interest Make It Out of Committee-Plus Budget Update

2011-03-16T17:37:00.002-04:00

Bills:
Two bills of importance to the disability community made it out of their respective committees today and are on the calendar tomorrow for a floor vote.

The first of these is Senate Bill 248: Update Archaic Disability Terms. This bill is being sponsored by Senator Fletcher Hartsell and it comes out of the General Statues Commission. The People First Language bill directed the General Statutes Commission to review all existing general statues and to update disability language as recommended. This is the first bill to come out of that study. The bill was heard today in the Senate Health committee and it received a unanimous favorable report.

The second bill is House Bill 234: Juror Qualifications/Disabilities. This bill will update a current state statute that prohibits people who are deaf of hard of hearing from serving on juries. Although the Administration of Courts has been using the federal laws, including ADA to provide equal access to the jury process, it is more than time that we bring our state statute into line with the federal laws. The second part of the bill will permit any person with a disability who feels that they can not adequately serve as a juror to request to be excused, to defer or be exempted from jury duty by making a signed statement of the request including a brief explanation of the disability. This bill also received a unanimous favorable report by the House Judiciary A committee. It will be on the House floor for a vote tomorrow.

Budget Updates:

This week the House and Senate Joint Health and Human Services Appropriation Subcommittee met to discuss the governor's budget. During the Tuesday meeting a motion was made to vote on the proposed governor's budget and to accept it as a starting point for further cuts. This was a very unusual motion to be made by the committee. Chairman Nelson Dollar explained to committee members that they still need to find an additional 357 million dollars in cuts to get to their targets.

The remainder of the weeks presentations will focus on Medicaid and CCNC. There has been no indication from the chairs as to when the actual budget process will begin or how it will work.

However, we did get a bit of insight into what might happen next from the Joint Education Appropriation Subcommittee. Today this subcommittee held its last information/presentation appropriation meeting. They will now begin the process of working with staff on a subcommittee budget report. The next called meeting will be to show that report.

Former Governor Sighting:

Governor Jim Hunt was in the General Assembly today educating the new leadership on the importance of Smart Start. Smart Start is the signature education program from Governor Hunt's administration.

Monday Quick Hits: Hot Policy Topics for This Week

2011-02-28T17:21:00.002-05:00

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.

NC News: GOP Leaders Set Budget Targets

2011-02-23T17:42:00.002-05:00

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.

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

2011-02-22T15:47:00.002-05:00

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

Issue
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

Conclusion
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

2011-02-22T08:49:00.002-05:00

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.

NCGA: State of the State Wrap Up

2011-02-14T20:07:00.002-05:00

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

2011-02-14T19:00:00.002-05:00

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 www.wral.com.

NCGA: State of the State Tonight

2011-02-14T18:03:00.002-05:00

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 Quick Hits: Hot Policy Topics for This Week

2011-02-07T10:44:00.002-05:00

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

NCGA: Wednesday and Thursday.

2011-02-02T05:09:00.002-05:00

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)

NCGA: What's up for the week

2011-01-31T20:50:00.003-05:00

Here we go with the budget. There will be a joint budget overview starting Tuesday at 8:30AM and again on Wednesday at 8:30AM.

This is when staff gets to present to the House and the Senate the budget details so that everyone starts their debates on a level playing field of knowledge.

And speaking of the budget, SB 13 has been filed by Senators Stevens, Brunstetter and Hunt which will give the governor more budget cutting powers in order to reach an additional $400 million in savings in the current budget (FY 2010). Quick reminder that the Senate sponsors for this bill are all the full appropriation chairs for the Senate.

In the House we are expecting to see the the Voter ID bill introduced soon. This bill will be sponsored by Representative Rick Killian and Representative Tim Moore. We will have more on this tomorrow.

NCGA: Press Conference on HB 2 Protect Health Care Freedom

2011-01-31T14:56:00.003-05:00

Today Representative Verla Insko held a press conference at the General Assembly to give the Democratic response to HB 2: Protect Health Care Freedom. This bill if signed into law would add North Carolina to the 28 state law suit against the health care reform act. It would exempt North Carolina from participating in the individual mandate coverage as required by the Affordable Care Act.

The reality of health insurance is the larger the insurance pool the more access there is to affordable health care for people with disabilities, pre-existing conditions and long term care needs. By mandating that all Americans have health insurance you create a large insurance pool. This is why the Affordable Care Act was able to remove pre-existing condition exemption, the cap on long term health expenditures, the ability to keep your child on your health insurance to age 26 and specifically for people with developmental and intellectual disabilities off a habilitation option in all base insurance plans.

The Arc of the US and its partner organizations worked tirelessly for the passage of this historic health care reform. People with developmental disabilities in 2014 will be able to secure their own affordable health insurance and in doing so quiet possibly lessen the need for full state assistance in long term care.

Then there is the reality of the health care crisis in North Carolina. Dr. Charles Van Der Horst stated that 1/3 of patients in hospitals in North Carolina today do not have health insurance. The cost of their care then transfers to those patients who do have insurance. The end result is an annual increase in health care costs of 9%.

Another speaker at today’s press conference, Libby Huff, told the story of her daughter who in 2009 was diagnosed with a genetic cardiac condition. The Huff family, for the most part, have always been self –insured. On average this family of four has paid out 18 thousand a year to be able to protect their family from catastrophic illness. In 2009 their daughter, while in the high school bathroom, suffered a heart attack. Thanks to an on site defibrillator this young woman was successfully transported to a hospital and after significant cardiac surgery survived this episode only to be diagnosed with a genetic heart condition. Under current health insurance it would be virtually impossible for her to secure affordable and accessible health insurance. However, with the passage of the Affordable Care Act she will be able to remain on her parents health insurance until the age of 26 and in 2014 she will be able to purchase health insurance for herself due to the removal of the pre-existing clause in current health insurance policies.

House Bill 2 would mean that for 4 million North Carolinians they would continue to be locked our of affordable health insurance because of their pre-existing conditions.

House Bill 2 will continue to move through the House over the next few days. We expect to see it hit the House floor sometime this week. We will continue to montior its progress and we will continue to cover this issue.

Monday Quick Hits: Hot Policy Topics for This Week

2011-01-31T12:05:00.003-05:00

This week kicks off the first full schedule of meetings at the NC General Assembly. So far not much in announced committee meetings but there will be a press conference today at 3:00 PM.

Here is the scoop on the press conference. As we reported earlier, House Republicans held a Judiciary meeting on Thursday to pass HB 2. This bill will require Attorney General Roy Cooper to put North Carolina into the lawsuit against the federal government and their requirement that all people must have health insurance, better known as the individual mandate.

There are a couple of reasons why this press conference and the bill are being tracked by The Arc of NC. First the bill, during a time when we are looking at a $3.7 billion deficit in the state budget, is the cost of litigating the federal Affordable Care Act advisable? Second, the individual mandate gives people with disabilities more access to affordable health care insurance. It does this by removing the pre-existing condition clauses, permits kids up to age 26 to remain on their parents insurance and it also stops insurance companies by ending benefits in the case of serious illness.

The press conference today will be lead by Representative Joe Hackney (D-Orange) minority leader of the House.

Here is the bill: HB 2 Protect Health Care Freedom.

NCGA: 2011 Session Opens and First Bills Are Filed.

2011-01-27T18:23:00.003-05:00

The contrast between yesterday and today could not have been clearer. If yesterday was all about pomp and pageantry then today was all about politics and policy.

Yesterday was indeed historic. For the first time in over 100 years the North Carolina House and Senate are now being lead by the Republicans. The day was full of events welcoming the new leaders and new members of the General Assembly to Raleigh. The first business of the session was the election of the chamber leadership, specifically the Speaker of the House and the Senate Pro Tempore. These decisions were made prior to the holiday break when both Republican caucuses met to nominate their leaders. The new Speaker of the House is Representative Thom Tillis from Mecklenburg and the new Senate Pro Tempore is Senator Phil Berger from Guilford and Rockingham.

As the evening festivities wrapped up the work of governing the state through a $3.7 billion deficit, the largest gap in revenue and spending since the depression dawned.

Today the newly sworn in Republican-controlled legislature got right to work debating their first bill.
House Judiciary 1 met 15 minutes after the completion of the House session. On the calendar was House Bill 2 Protect Health Care Freedom:
This bill would block the implementation in our state of the independent mandate for health insurance that is part of the Affordable Care Act (federal health care reform).

During the Senate’s first official session, the members found out their official committee assignment. The first bill of interest from the Senate will be to eliminate the cap on charter schools in our state. Senate Bill 8 No Cap on Charter Schools:

This bill would remove the current statutory cap on the number of charter schools in the state.

NCGA: Session About to Start Here is What to Expect

2011-01-24T08:12:00.001-05:00

We are just a few days away from the beginning of the 2011 North Carolina legislative session. This session will begin with a historic transition of power. During the 2010 election, the Republicans gained control of both the House and Senate. This will be the first time in over 100 years that Republicans will be our states leadership and with that control comes the responsibility to balance the state budget.

The reality of this session is that regardless of which party was in leadership, our state is facing a $3.7 billion deficit. The budget deficit is over 15% of the state’s total fund expenditure.

So how did we get to a $3.7 billion deficit?
Several factors have caused this significant deficit. Let’s start with the “great recession”. Although multiple economists believe we have hit the bottom and are slowly coming out of it, our state revenue collections have been slow to respond. This is not just happening in our state but also across the nation.

Then there are policy factors that are adding to the deficit. This is the break down of those factors:

1. Federal American Recovery and Reinvestment Act of 2009 funds will expire with the 2010 budget. Total amount not recurring is $1.6 billion
2. The state sales tax and additional taxes that were passed during the 2009-2010 legislative sessions will expire on June 30, 2011. Totally amount not recurring is $1.3 billion.
3. Lastly, there are $300 million in one-time reductions and transfer of fund balances in the current 2010 budget. These one time reductions return to the continuation budget on June 30,2011.
The total of just these three policy factors had our state at a deficit of $3.2 billion.

In addition to these there are several other factors that have brought our state to the $3.7 billion deficit figure. These are the additional preliminary estimates on needed revenue:

$75 million for public schools-K-12 enrollment growth.
$190 million for Medicaid enrollment growth.
$89 million for higher education enrollment growth.

$181.6 million to maintain the current benefit levels and anticipated growth in the North Carolina State Health plan for state employees.

$304.9 million from the General Fund and $13.6 million from the Highway Trust Fund to the State Retirement System to increase the employer contribution to the national standards.

And finally unspecified appropriations will need to be directed at the Savings Reserve Account (Rainy Day Fund), Capital and Repair and Renovations Reserve Account, and Economic Development.

What are leaders saying about how to close the deficit?

Both Governor Perdue and the new Republican leadership are stating that there will be no new taxes offered to help close this gap and no extension of the current tax package.

Governor Perdue had requested all of the state divisions and departments to prepare budgets that reflected a 5%, 10% and 15% cut to their current budgets. In addition the governor has presented a plan to consolidate, eliminate and privatize specific sections of our state government.

The Republican leadership, in multiple news interviews, has pointed to the reduction of budgets through cuts, consolidation of government agencies, and “zero-based” budgeting (defending programs based on their effectiveness and fiscal responsibility.)

As the clock ticks down to the start of a new session, the cuts are most likely to be at least 15% -18% of the current budget.

What is the impact of cutting a budget by 15% to 18% for developmental disability services?

This budget year is critical with both long and short-term implications for people with developmental disabilities and their families. Reductions of 15% to 18% of our developmental disability budget would devastate supports and services. The cuts would be even deeper since a majority of our services are provided through Medicaid funding which receives a 66 % match from federal funds. For example if the state were to cut 50 million from Medicaid funded Developmental Disability services the actual cut would be close to 150 million.

In addition we are likely to see significant cuts in education specifically around teaching assistant positions. With the multiple plans to consolidate and cut services in public health and other social services, we will see a crisis compounded by multiple cuts that will affect the developmental disability community.

What can you do to help legislators understand the personal impact of the upcoming budget crisis?

Here is what we suggest.

1. Get to know your legislator. Make contact with him or her now, before session begins. If you receive services in this state, tell them your personal story.
2. Sign up for e-alerts from The Arc of North Carolina and for our upcoming bi-weekly publication, “Policy Partners” designed to provide more analysis and review of actions taken in Raleigh.
3. Keep up with The Arc of North Carolina Policy blog as we update daily the happening at the North Carolina General Assembly.
4. Follow us on Twitter at thearcnc. We will be using Twitter to get breaking policy news out to you directly from the General Assembly.
5. Participate in lobbying days at the General Assembly. Find out more about our lobbying efforts during the session by visiting The Arc of North Carolina web site.

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

2011-01-18T17:39:00.002-05:00

Tomorrow will be, most likely, the last of the Joint Legislative Oversight Committee meetings for this interim. Here is the new agenda. (Please note the early start time.)

Joint Legislative Oversight Committee on
Mental Health, Developmental Disabilities, & Substance Abuse Services
DRAFT AGENDA

January 19, 2011 9:30A.M.; Room 643, Legislative Office Building
Representative Verla Insko, Co-Chair, Presiding

9:30
Welcome and Opening Remarks Senator Martin Nesbitt, Co-Chair
Representative Verla Insko, Co-Chair

9:30-10:00
CABHA Update Beth Melcher, Ph.D., Assistant Secretary for Mental Health, Developmental Disabilities & Substance Abuse Services Development, DHHS

10:00-10:30
LME Medicaid Utilization Management Staff, Eastpointe Ellen S. Holliman, Area Director, The Durham Center

10:30-11:00
Residential Services for Children Ages 0-6 with Developmental Disabilities Deborah Carroll, Ph.D., Head of Early Intervention Branch, Women & Children's Health Section, Division of Public Health Rose Burnett, DD Project Manager, Division of Mental Health, Developmental Disabilities & Substance Abuse Services

11:00-11:30
Draft Report& Committee Discussion

11:30
Final Remarks & Adjournment

NC News:Governor Beverly Perdue Announce Her Plan to Restructure NC Government

2010-12-09T16:01:00.002-05:00

Facing a growing budget deficit (current estimates are a 3.7 billion dollar budget gap) Governor Beverly Perdue released today her plan to re-structure state government. Here goal is to “streamline state government and save money”.
Speaking in Pinehurst to several area chambers of commerce, Governor Perdue stated that she is proposing a hiring freeze in state government, the elimination of support functions such as human resources, and the consolidation of several state agencies.

The proposal for consolidating agencies would take state government from 14 agencies down to 8 agencies.

Here are some of the details of the governor’s proposal:
-Consolidate the departments of Juvenile Justice, Correction and Crime Control and Public Safety will merge and become one Department of Public Safety.
-Department of Commerce will absorb the Employment Security Commission.
-Department of Administration will change to the Department of Management and Administration and will take up the tasks of chief operations unit for state government, absorb information technology, the Office of State Personnel and the controllers office.
-Privatization of purchasing function and IT consolidation through a different private company.
-Human Resources would move out of state government to a private company, as part of the outsourcing of state functions.
-Hiring freeze in all cabinet agencies. The governor also called on members of the Council of State to follow her lead and freeze all hiring of non critical positions.
-Governor Perdue will also present to lawmakers a list of 150 state boards and commissions that could be eliminated. North Carolina currently operates 400 state boards and commissions.

NC News:Under the Dome Reports A Bigger Budget Deficit Looms for NC General Assembly

2010-12-08T11:15:00.003-05:00

Today the National Conference on State Legislators released a report detailing that budget problems will persist over the next three years for many states. The News and Observer, Under the Dome offers this budget picture for North Carolina based on the NCSL report.

Bigger budget hole

Submitted by lbonner on 2010-12-08 10:39
Tags: Under the Dome | Bev Perdue | budget | legislature | National Conference of State Legislatures

Is it $3.2 billion? $3.5?

The budget hole state politicians will look to fill next year may be bigger than commonly reported.
A new report from the National Conference of State Legislatures on budget conditions in the 50 states and Puerto Rico puts the hole North Carolina is facing at more than $3.8 billion, or 20.3 percent of current budget. NCSL collected information for its report from legislative fiscal offices.

In North Carolina, you start at $3.2 billion, which comes from the loss of federal stimulus money and the expiration of temporary state sales taxes and income tax surcharges.

Here's the rest:
In addition to the previously reported gap estimate of $3.2 billion is an increase of $300 million for the state retirement system, $181.6 million for the health plan for state employees and retirees and $164 million of education enrollment growth ($34 million for community colleges, $55 million for the UNC system and $75 million for K-12 education). Medicaid enrollment growth in FY 2012 is unknown at this time. It should be noted that the general fund base is FY 2011 and does not include ARRA funds.

Gov. Bev Perdue is going to talk about government reorganization tomorrow, offering something of a nonspecific preview to the budget she'll present early next year.

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

2010-12-07T06:54:00.002-05:00

On Wednesday, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities and Substance Abuse Services will meet. This is the draft agenda for the meeting.

AGENDA
December 8, 2010 10:00 A.M.; Room 643, Legislative Office Building
Senator Martin Nesbitt, Co-Chair, Presiding

10:00
Welcome and Opening Remarks Senator Martin Nesbitt, Co-Chair
Representative Verla Insko, Co-Chair

10:00-10:15
Secretary's Remarks
Lanier Cansler, Secretary
Department of Health and Human Services

10:15-10:45
ICF-MR Cost Analysis and Comparison w/
CAP/MRDD Services
Steve Jordan, Director,
Division of Mental Health, Developmental
Disabilities, & Substance Abuse Services

10:45-11:15
State Operated Developmental Centers -Carol Donin, Team Leader, Developmental
Centers, Division of State Operated Health Care Facilities, DHHS
Dr. Aleck Myers, Director. Murdoch Center

11:15-11:45
Residential Services for Children
Ages 0-6 with DD - Presenter,TBD

11:45-12:00
Update on Medicaid Waiver for
Traumatic Brain Injury Kelly Crosbie, LCSW, Behavioral Health Mgr.
Division of Medical Assistance, DHHS

LUNCH

1:00-1:30
Transfer of Utilization Review to LMEs
CAP/MRDD Services Kelly Crosbie, LCSW, Behavioral Health Mgr. Division of Medical Assistance, DHHS

1:30-2:00
Mobile Crisis- Service Gaps Beth Melcher, Ph.D, Asst. Secretary for Mental
Health, Developmental Disabilities, & Substance Abuse Service Development, DHHS

2:00-2:30
Post-Hospitalization Continuity of Care Peter E. Rives, Care Coordination Manager, CenterPointe Human Services LME

2:30-3:00 Public Comments

3:00 Closing Comments & Adjournment

NC News: Leadership Changes for the New General Assembly

2010-11-30T09:18:00.002-05:00

As we begin to prepare for the upcoming legislative session new leaders are beginning to emerge.

In the House, the GOP leadership met before Thanksgiving to caucus on their choice for Speaker of the House. Representative Thom Tillis (Mecklenburg) emerged as the new leader of the House. Representative Paul "Skip" Stam (Wake) will be the new majority leader.

In the Senate, the Senate Pro-Tempore will be Senator Phil Berger (Guilford,Rockingham) and the majority leader with be Senator Harry Brown (Jones, Onslow). The rules chair position will fall to Senator Tom Apodaca(Buncombe, Henderson, Polk).

More leadership positions will be announced over the next few weeks as we move closer to the start of session.

NC News: N&O Article US Department of Justice Open Probe of NC Mental Health System

2010-11-29T10:50:00.002-05:00

On the Wednesday before the Thanksgiving holiday, the N&O Under the Dome reported that the U.S. DOJ will be investigating the North Carolina Mental Health system. Here is the article:

Feds launch probe of N.C. mental health system

RALEIGH The U.S. Justice Department has opened a formal investigation into North Carolina's struggling mental health system, the first step in a process that could trigger a federal edict for sweeping reform.

The probe is the result of a complaint filed in July by the advocacy group Disability Rights North Carolina, which contends that the state is violating the Americans With Disabilities Act for failing to provide proper housing for people with mental illness.

Nearly a decade after the state Department of Health and Human Services closed thousands of beds in government-run psychiatric hospitals as part of a reform effort, more than 6,400 people with severe mental illness are housed in adult care homes scattered across the state, living in sometimes squalid and dangerous conditions.

The mental patients, their care typically paid for with taxpayer money, are often far younger than the elderly residents with whom they are housed. In the last two years, at least four residents with mental illness have been killed by fellow patients who had histories of severe mental illness and violence.

Vicki Smith, the executive director of Disability Rights, said the federal investigation could force the state to take actions to fix the mistakes made during North Carolina’s 2001 reform effort, which has also resulted in people with mental illness routinely languishing for days in emergency rooms because no bed in a psychiatric facility is available.

Word of the federal investigation also comes as the state is debating further cuts to the state’s mental health system and moving to close Dorothea Dix Hospital.

“Now DHHS is going to have to answer a whole series of questions about why mental health reform has failed,” Smith said. “This is huge, from our point of view. Huge.”

The Justice Department informed the state of its pending investigation through a five page letter received by DHHS administrators in Raleigh on Thursday. However, the state department did not publically reveal the news until it issued a three-sentence media release earlier today, hours before the start of the Thanksgiving Holiday.

Renee McCoy, a spokeswoman for the state agency, said there would be no comment beyond the media release, which said the state will “work with the Department of Justice to provide all necessary documents and information in response to the complaint.”

NC News: N&O Article More Information on Investigation at J Iverson Riddle Developmental Center

2010-11-19T07:27:00.001-05:00

Longtime abuses feared at state home for disabled

RALEIGH Investigators probing the abuse of residents of a state-run home for people with mental disabilities in Morganton are studying records of unexplained injuries going back years.

The state Department of Health and Human Services announced this week that eight state workers were fired and a temporary employee dismissed over a case of abuse on Oct. 24. Two workers were fired for abusing residents, while others were dismissed for failing to report the abuse or falsifying medical records to cover up the cause of the injuries.

On Thursday, the department confirmed that the abuse of residents at the J. Iverson Riddle Developmental Center could be more widespread than the incident last month, during which a resident suffered a fractured toe, bruises and abrasions.

On Sept. 26, a resident sustained a fractured finger that is now alleged to have been caused by a staff member.

The abuse allegations center on Hemlock House, a residence for adults with such severe cognitive impairments they need staff assistance with routine tasks such as eating, bathing and brushing their teeth. Some of the residents can't speak.

The families of the residents injured in September and October have been notified of the investigation, said Mark Van Sciver, a spokesman for DHHS.

In a written statement, the spokesman said that employees interviewed during the preliminary investigation raised questions about past injuries that had previously been reported as being of "unknown origin." Resident injuries written up as accidents are also now being re-examined, Van Sciver said.

No criminal charges have been filed. The agency has also not released the names of the employees fired.

In a written statement, Riddle Center Director Art Robarge said Thursday that he wanted to send a clear message to his staff that it is never acceptable for an employee to observe abuse and then fail to report it.

"I will do everything in my power to ensure that those who failed to report these incidents cannot hide behind the claim of being afraid of retribution as their reason for failure to report," Robarge said. "This kind of failure to carry out duties to protect our most vulnerable population is inexcusable and will not be tolerated."

NC News: N&O Article on 9 Fired After Abuse Report at State Home

2010-11-18T14:53:00.000-05:00

9 fired after abuse report at state home

Nine workers at a state home for people with developmental disabilities in Morganton have been fired after an alleged case of abuse and the failure to report patient injuries.

The employees at J. Iverson Riddle Developmental Center were placed on leave after a series of incidents that took place the weekend of Oct. 22, according to a news release issued by the state Department of Health and Human Services. The nine workers were fired after an internal investigation.

The state did not release the names of the workers fired, but the release said they included two developmental disabilities trainers terminated after allegations of abuse against them were substantiated. A licensed practical nurse, a temporary employee and four developmental disabilities trainers also were fired for failing to report abuse; and one developmental disabilities trainer was terminated for falsification of records and failing to report abuse.

"Any situation or incident involving the injury of any person in our care is treated with an immediate and thorough investigation," Art Robarge, the facility director, stated in the release.

"We have pursued this investigation vigorously and will take whatever steps we need to protect the dignity and safety of our residents. This facility has a long-standing policy that any and all cases of abuse must be reported immediately without exception."

A criminal investigation of the abuse was initiated by Broughton Public Safety, the internal police department at the state mental hospital next to the Riddle Center. Based on the center's internal investigation, officials with the Burke County Department of Social Services were notified and have referred information to the district attorney for possible prosecution.

Mark Van Sciver, a DHHS spokesman, said no criminal charges had been filed.

Hill Report: National Council on Disability Celebrates 35 Years of the IDEA

2010-11-18T06:24:00.001-05:00

National Council on Disability Celebrates 35 Years of the Individuals with Disabilities Education Act

WASHINGTON, Nov. 17, 2010 /PRNewswire-USNewswire/ --The National Council on Disability (NCD) celebrates 35 years of the Individuals with Disabilities Education Act (IDEA), a law designed to ensure a free and appropriate public education for every child with a disability.
Prior to the law's enactment, millions of students with disabilities were excluded from the public school system and were denied access to a public education. In 1975, Congress enacted and President Gerald Ford signed the Education for All Handicapped Children Act, one of the most important civil rights laws ever written. The central premise of this federal law, now known as IDEA, is that all children with disabilities have a federally protected civil right to a free appropriate public education that meets their education and related services needs in the least restrictive environment.

Read more here.

NC News: N&O Article on State Health Plan

2010-11-17T10:30:00.001-05:00

State could shift health plan oversight

RALEIGH Oversight of the financially strapped North Carolina health insurance plan for 665,000 state employees, retirees and their dependents should shift from the General Assembly to an executive branch agency to operate it more efficiently, a legislative task force concluded Tuesday.

The panel, made up of lawmakers, state officials, health experts and state employee advocates, also agreed the State Health Plan for Teachers and State Employees needs a strong and independent governing board that can make policy decisions and hire and fire the plan's chief executive officer.

State law right now gives the final say on the chief executive to the chairmen of the legislature's oversight committee, which also has become more involved micromanaging plan benefits to help fill gaping fiscal holes between premiums and more than $2.5 billion in health care expenses annually. The legislature approved a $675 million bailout of the plan last year that raised premiums for dependents and eroded benefits.

An outside consultant's report said the current structure of the plan as an independent agency doesn't ensure adequate oversight and monitoring, and the plan's current trustee board is too weak.

The proposal would make the health plan just like any other state agency that would have to seek funding annually, said Rep. Hugh Holliman, a Democrat from Lexington who is a co-chairman of the task force and the current oversight committee. But Holliman said it's clear day-to-day operations shouldn't be performed by the legislature.

Critics of the health plan said shifting oversight to the executive branch and creating a board with more authority would give health experts greater influence and limit political interference that has led to a poorly run plan.

Holliman warned that shifting the plan to the executive branch won't eliminate increasing health care expenses for state employees and their dependents. The plan could require an additional $572 million through mid-2013 to maintain current benefit levels and handle more patients, according to the legislature's analysts.

Rep. Dale Folwell, a Winston-Salem Republican who is a likely leader on State Health Plan issues in the new GOP majority next year, was displeased because the recommendation didn't discuss how to reduce the state's $33 billion unfunded liability for the projected medical expenses of state government retirees.

Monday Quick Hits: Hot Policy Topics for This Week

2010-11-15T09:52:00.003-05:00

A start of a new week of interim meetings is happening this week. Of interest, is the fact that these interim committees are currently chaired by Democrat leadership. With the swing to Republican leadership in both the House and Senate, these meetings are taking on a different task. Multiple times during the Joint Legislative Oversight Committee on MH/DD/SAS there were comments from the chair regarding what the new leaders will need to look at and what challenges they face. We expect that to continue over the next two months.

Also of interest, the NC GOP members in the House and Senate will be holding their caucus on November 20th. During their caucus they will choose the new Speaker of the House and the new Senate President Pro Tempore. We will report on these choices once they are released.

Until then, here is the calendar for the week:
Tuesday, November 16, 2010
10:00 AM Blue Ribbon Taskforce on State Health Plan 1228/1327 LB

Wednesday, November 17, 2010
9:00 AM Joint Legislative Program Evaluation Oversight Committee 544 LOB

Thursday, November 18, 2010
10:00 AM Child Fatality Task Force - Perinatal Health Committee 1027/1128 LB
10:00 AM Subcommittee on Domestic Violence Funding 1425 LB
10:00 AM Childhood Obestity Taskforce Planning Meeting 415 LOB
2:00 PM Urban Growth Study Committee 1027/1128 LB

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

2010-11-05T22:59:00.002-04:00

On Tuesday, November 9th the Joint Legislative Oversight Committee on MH, DD, SAS will meet. Here is the proposed agenda:

Joint Legislative Oversight Committee on
Mental Health, Developmental Disabilities, & Substance Abuse Services
AGENDA
November 9, 2010 10:00 A.M.; Room 643, Legislative Office Building
Representative Verla Insko, Co-Chair, Presiding

10:00 Welcome and Opening Remarks Senator Martin Nesbitt, Co-Chair Representative Verla Insko, Co-Chair

10:00-10:30 Secretary's Remarks
Dorothea Dix Closure Lanier Cansler, Secretary
Department of Health and Human Services

10:30-10:45 Expenditures & Utilization Tracking Update
Dr. Craigan Gray, Director Division of Medical Assistance, DHHS

10:45-11:15 LME Presentation/TASC
Mr. Mike Kupecki, Assistant Area Director East Carolina Behavioral Health

Michael Gray the Vice President of Region 3 TASC, Partnership for Drug Free NC and
Vice President of National TASC

Karen V. Chapple, Executive Vice President of Coastal Horizons Center and Immediate Past President of National TASC.

11:15-11:45 Three-Way Contracts Update
Mr. Mike Watson, Deputy Secretary for Health Services, DHHS

11:45-12:45 Lunch

12:45-1:45 ICF-MR Cost Analysis and Comparison w/ CAP/MRDD Services
Steve Jordan, Director, Division of Mental Health, Developmental Disabilities, & Substance Abuse Services, DHHS

1:45-2:15 Overview of the DD Waiting List
Rose Burnette, DD Project Manager Division of Mental Health, Developmental Disabilities, & Substance Abuse Services, DHHS

2:15-2:45 Update on CAP-MR/DD Tiered Waivers
Rose Burnette, DD Project Manager, Division of Mental Health, Developmental Disabilities, & Substance Abuse Services, DHHS

2:45-3:00 Public Comments

3:00 Closing Comments & Adjournment

NC News: WRAL Reports on GOP and State Budget Cuts

2010-11-05T14:40:00.002-04:00

WRAL Article: GOP warning of impending budget cuts alarms some

Posted: 5:43 p.m. yesterday
Updated: 6:34 p.m. yesterday
Top Republican lawmakers say their plans to balance the state budget next year solely through spending cuts will likely be painful for many people.

Fiscal analysts have projected a budget deficit of more than $3 billion, and Republican leaders in the General Assembly said after their election victories Tuesday that they want to reduce the budget to about $16 billion from the $19 billion spending plan passed in June.

House Minority Whip Thom Tillis, a potential candidate to become the next House speaker, said Wednesday that the cuts could lead to "legitimate, sad stories about people who may end up suffering."

Ellen Russell, director of advocacy and chapter support at The ARC of North Carolina, which serves people with mental retardation and other developmental disabilities, warned Thursday of the ripple effect from drastic state cuts.

"It is terrifying to us because there are 7,000 people with intellectual and developmental disabilities on the waiting list (for service) in this state now," Russell said. "There are (also) a lot of people employed in the field of services for people with mental health, developmental disabilities and substance abuse services."

In addition to eliminating nonprofit positions, there is also concern that cuts could lead to widespread layoffs among state workers.

Dana Cope, executive director of the State Employees Association of North Carolina, said there are areas in the state budget that can be cut, but state jobs is not one of them.

"The folks who've been out of power who now assume power are going to have a good education in what it takes to run government," Cope said of the Republicans. "They will feel the wrath not only of public employees, but they're going to feel the wrath of taxpayers who have come to depend on those quality public services."

University of North Carolina President Erskine Bowles even suggested that deep budget cuts could force the closure of one of the UNC system's 16 university campuses.

Staff at the campuses have been drafting budget scenarios for the UNC Board of Governors to give them options for cutting 5 to 10 percent of the system budget next year.

A 10 percent cut would be about $270 million, and Bowles said that would mean laying off about 1,800 faculty and staff members across the system.

Campuses would also have to increase class sizes and reduce the number of courses offered to handle the cuts, he said.

"Where it gets hard is if you have to go beyond that," he said. "Let's say we had a 20 to 30 percent cut. Then, you have to start looking at some real extremes. Are you better to really damage the entire quality across the board, or are you better off talking about closing down one campus?"

Bowles said such a move isn't being contemplated now, but it might be considered if proposed spending cuts become deeper.

The Board of Governors is expected to vote Friday on a budget proposal to send to lawmakers.

Reporters: Bruce Mildwurf, Erin Hartness
Photographers: Terry Cantrell, Pete James
Web Editor: Matthew Burns

Election 2010: Results Wrap Up

2010-11-04T10:00:00.001-04:00

Election 2010: Results Wrap Up
The 2010 Election is over and now we know who will lead North Carolina during the next legislative session. After a very heated and hard fought campaign season, the North Carolina Republican party ended Tuesday night with control of both the House and Senate.

Here are the breakdown of numbers as compiled by the AARP-North Carolina.

Current General Assembly make up:
Senate – 30-20 Dem majority
House – 68-52 Dem majority

2011 General Assembly make up:
Senate – 31-19 GOP majority
House – 68-52 GOP majority

What this means for people with developmental and intellectual disabilities in North Carolina?

The first thing that will happen is that all of the major committees that we work with will have new leadership. We will see significant changes to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Service. In addition we will see a political structure where the state house will be run by Republicans while the Executive Branch will be run by Democrats.

Regardless of who leads the state house, real challenges remain. The state of North Carolina will be facing at least a $3.5 billion deficit as we begin the next legislative session. We will also be looking down line to the implementation of health care reform in our state. North Carolina continues to see significant unemployment numbers. These challenges and their solutions now fall on the shoulders of the Republican party.
Posted by Julia Leggett at 6:47 AM 0 comments

2010-11-02T08:07:00.002-04:00

We will be reporting all election results as they become available on our Election 2010 Blog. Please visit us tonight!

Here is where we will be!!

Election 2010: Today Is Election Day!!!!

2010-11-02T08:00:00.002-04:00

Good Morning North Carolina! Today is Election Day!! The polls have been open for over an hour now and we encourage you to Go Vote!!!

Polls in North Carolina will be open from 6:30 AM until 7:30 PM.

If you need to know where your polling place is please visit the North Carolina Board of Election website.

If you are a North Carolinian with a disability here are your rights:

MY VOTING RIGHTS
As a voter with a disability I have the right to:
1) Not be denied my right due to a disability.
2) Vote if I am in line before the polls close.
3) Choose a person to help me, but this person cannot be my employer or an agent of my employer or union.
4) Be reassigned before the election to a site accessible to me.

WAYS TO VOTE
1) Voting inside the polling site…..usually accessible, but maybe not for all
2) Curbside voting….If you can get to the voting site, but can’t get into the building because of your disability, a poll worker can come to your vehicle.
3) Absentee Ballot by mail….Any registered voter is authorized to vote by mail using an absentee ballot.
4) Absentee One-Stop (No excuse)…Allows voters to vote in person ahead of the election by up to 19 days.
5) Satellite voting sites…Some counties establish a plan that allows voters with disabilities to vote at designated sites.

WHAT IF I HAVE TROUBLE
1) Laws protect your right to register and vote
2) Call the County Board of Elections and State Board of Elections
3) Call Disability Rights NC
4) You may always vote a provisional or contested ballot

If you have problems voting, please report the incident by calling:

The NC State Board of Elections at 866-522-4723.

Democracy North Carolina at 888-OUR-VOTE.

Election 2010: Tomorrow is Election Day

2010-11-01T09:08:00.004-04:00

If you did not take the opportunity to early vote, we encourage you to make plans to VOTE tomorrow, Tuesday November 2.

November 2, 2010 is Election Day in North Carolina. This is going to be a very important and very tight election. The reality is that every vote will count and every vote will have an impact!

We encourage you to vote!

If you need to locate your polling place, visit the State Board of Elections Polling Place Locator.

If you are a North Carolinian with a disability here are your rights:

MY VOTING RIGHTS
As a voter with a disability I have the right to:
1) Not be denied my right due to a disability.
2) Vote if I am in line before the polls close.
3) Choose a person to help me, but this person cannot be my employer or an agent of my employer or union.
4) Be reassigned before the election to a site accessible to me.
WAYS TO VOTE
1) Voting inside the polling site…..usually accessible, but maybe not for all
2) Curbside voting….If you can get to the voting site, but can’t get into the building because of your disability, a poll worker can come to your vehicle.
3) Absentee Ballot by mail….Any registered voter is authorized to vote by mail using an absentee ballot.
4) Absentee One-Stop (No excuse)…Allows voters to vote in person ahead of the election by up to 19 days.
5) Satellite voting sites…Some counties establish a plan that allows voters with disabilities to vote at designated sites.
WHAT IF I HAVE TROUBLE
1) Laws protect your right to register and vote
2) Call the County Board of Elections and State Board of Elections
3) Call Disability Rights NC
4) You may always vote a provisional or contested ballot

If you have problems voting, please report the incident by calling:

The NC State Board of Elections at 866-522-4723.

Democracy North Carolina at 888-OUR-VOTE.

NC News: Important Headlines-Sterilization Victims Hotline

2010-10-27T07:09:00.003-04:00

Hotline Number:
N.C. Justice for Sterilization Victims Foundation. 1-877-550-6013 (toll free in North Carolina) or 919-807-4270.
The hotline is open Monday through Thursday from 10:00 AM until 4:00 PM.

If you believe that you were a victim of North Carolina sterilization program you are encouraged to call this hotline.

Background:
In North Carolina 7,600 people were forcibly sterilized between 1929 and 1970’s. Many of those who were sterilized were young adults and teens with intellectual disabilities or mental illness. Many of the young women sterilized during the 1960’s were black women and girls.

North Carolina’s sterilization laws were repealed in July of 2003. At that time Governor Mike Easley apologized on behalf of the state for this practice.

Throughout the United States over 60,000 Americans were legally sterilized against their will during the 20th century.

“North Carolina Assembly Strikes Sterilization Law”, By Dave Reynolds, Inclusion Daily Express -July 22, 2003

News Articles:

Hotline launched to help state's eugenics victims
Posted by Lisa Sorg on Tue, Oct 26, 2010 at 3:48 PM
If you believe you were forcibly sterilized under the authority of the N.C. Eugenics Board, you can call a toll-free hotline for information about the program.
The N.C. Justice for Sterilization Victims Foundation is operating the hotline. The number is 1-877-550-6013 (toll-free in North Carolina) or 919-807-4270. It is open 10 a.m. to 4 p.m. Monday through Thursday.

The Eugenics Board program operated between 1929 and 1974. Persons impacted by the N.C. Eugenics Board program were born in or prior to 1961.

Read Indy Article Here.

Sterilization Victims Hotline (The Insider and The Associated Press Report)
The N.C. Justice for Sterilization Victims Foundation announced Tuesday the establishment of a toll-free number for callers to provide information and confirm the identification of someone who was sterilized under the authority of the North Carolina Eugenics Board. More than 7,600 people were sterilized by choice or coercion under the state program between 1933 and 1973. Callers will have to fill out a verification form. Gov. Beverly Perdue created the foundation to determine how to compensate victims. But there's no money set aside right now for that assistance. The foundation said verification doesn't guarantee the person will receive compensation.(THE ASSOCIATED PRESS, 10/26/10).

NC News: More Details on Medicaid Settlement

2010-10-26T10:43:00.001-04:00

The Winston Salem Journal has an excellent break down on the $3.5 million Medicaid settlement.

N.C. Medicaid to get $3.5M
By RICHARD CRAVER | JOURNAL STAFF REPORT
Published: October 24, 2010

Raleigh, N.C. --
The N.C. Department of Health and Human Services says that the state Medicaid division will get more than $3.5 million from recent agreements with five pharmaceutical manufacturers to settle cases of kickbacks.

The five settlements total nearly $17.5 million. The federal government, which pays about 70 percent of N.C. Medicaid expenses, received most of the restitution.

The largest settlement was with AstraZenaca PLC for $13.8 million. N.C. Medicaid received about $2.4 million in restitution and interest, and the state’s public schools received $2.35 million in penalties.

Other pharmaceutical companies’ settlements with N.C. Medicaid are:

• $839,058 from Omnicare for a range of false-claims violations arising from its dealings with various nursing-home chains and drug manufacturers.

• $105,454 from Alpharma, the manufacturer of Kadian, for paying for resort trips for health-care providers. .

• $137,631 from IVAX Pharmaceuticals, a manufacturer of generics, for its dealings with Omnicare.

• $30,360 from Novartis, the manufacturer of TOBI, for alleged encouragement of off-label prescribing.

NCGA: State Budget Deficit Update October

2010-10-22T12:49:00.003-04:00

This week members of the Government Operations committee received an updated report from fiscal staff on the state of the budget deficit for fiscal year 2011.

The presentation stated that the overall economy is in a stagnant, slow growth pattern. This slow growth trend will be with us through the remainder of 2010 and well into 2011. This trend will also show elevated unemployment rates for all of 2011.
In a recent report the North Carolina unemployment rate dipped from 9.7% in August to 9.6% in September. However, new unemployment claims rose. This is what the report stated we should expect to see continue through all of 2011.

Overall collections through September are running $18 million below the $4.5 billion target due primarily to processing delays. Dr. Barry Boardman (fiscal research staff), stated that we are poised to turn the quarter on tax revenue collections but that is was to early to say we are off and going toward sustained growth.”

Even with all the tempered positives we are still facing between a $3.2 to $4 billion deficit as we enter into the 2011 fiscal year.

Here are some of the other statistics presented to the committee:

Sales Tax:
Starting in July collection declines came to an end as year-over-year collections were up in each month, but by less than 1% (baseline).

Withholding and Employment:
Recent withholding collections (wage & salary income taxes) offer a glimmer of hope that this key revenue source (40% of total General Fund revenue) is poised to move into positive growth territory.

Through September, net withholding (all wage & salary withholding less refunds) was down 0.5%. This time last year, net withholding was down by 3.5%.

How we get to a $3.2 – 4 Billion Deficit:
Total General Fund Availability for FY 2010-11 was $18.956 billion (S.L. 2010-31)
• Includes $1.6 billion in federal dollars (ARRA Funds)
• Includes $1.3 billion in temporary Sales Tax & Income Surtax
• Includes other one-time items totaling about $300 million

In addition to the $3.2 billion less in FY 2011-12 availability, the General Assembly will face:

• Mandated spending pressures from Medicaid and Public School Enrollment
• Additional spending pressures include
An estimated $572.4 million is needed over the next biennium to maintain
current benefit levels and anticipated growth in the State Health Plan;

Additional funds may be needed to increase the State’s employer contribution to the State Retirement System depending on the results of the System’s annual actuarial valuation. (This may possibly be as high as 1.2 billion)

Post-Secondary enrollment growth

To view the power point presentation on the budget update-go here.

NC News: Under the Dome-N.C. Shares in Medicaid Settlement

2010-10-22T10:55:00.001-04:00

N.C. shares in Medicaid settlements-Under the Dome
Submitted by lbonner on 2010-10-20 17:18

North Carolina is sharing in nationwide Medicaid settlements with four drug companies and a nursing home pharmacy provider over alleged improper promotional activities, kickbacks, or improper attempts to sway doctors to prescribe a drug.
Most of the $17.5 million that's the state's share of the settlements will go to the federal government, which pays about 70 percent of the state's Medicaid costs. The public schools will get a share of two of the five settlements.

The largest settlement is with AstraZeneca to settle claims that it allegedly engaged in an off-label marketing campaign for a drug that treats schizophrenia and bipolar disorder. N.C. Medicaid is getting $2.4 million in the settlement, and the public schools get $2.35 million.

Omnicare, which provides pharmaceutical services to long-term care facilities, settled false-claim allegations arising from its dealings with various nursing home chains and drug manufacturers. N.C. Medicaid's share is $839,058.
Alpharma allegedly provided doctors with training programs and research grants, and made false claims about the drug, Kadian, to convince them to prescribe it. N.C. Medicaid's share is $105,454 and the schools get $105,837.
IVAX Pharmaceuticals, for alleged violations of kickback laws. N.C. Medicaid's share is $137,631.
Novartis allegedly encouraged off-label prescribing of a drug that treats lung infections. N.C. Medicaid's share of the settlement is $30,360.
Correction: North Carolina's share of federal settlements. N.C. Medicaid will keep $3.5 million.

Read more: http://projects.newsobserver.com/under_the_dome/nc_shares_in_medicaid_settlements#ixzz1368U6NOW S

NC News: Reminder-Early Voting Starts Today

2010-10-14T10:32:00.002-04:00

We encourage you to take advantage of Early Voting. This is an important election. The state of North Carolina is looking at a 3 to 4 billion dollar deficit in our state budget.

Take time to learn about the candidates and take any opportunity in your local communities to meet your candidates. Then vote!

NC News: ACLU Files Lawsuit After Government Wrongfully Deports U.S. Citizen with Mental Disabilities

2010-10-14T10:22:00.002-04:00

American Civil Liberties Union of North Carolina
Legal Foundation

P. O. Box 28004, Raleigh, NC 27611-8004
Phone: (919) 834-3466 Fax: (866) 511-1344 Email: aclunc@nc.rr.com

*** PRESS RELEASE *** PRESS RELEASE *** PRESS RELEASE ***

ACLU Files Lawsuits After Government Wrongfully Deports U.S. Citizen With Mental Disabilities

Case Highlights Lack Of Due Process In Immigration Detention System

FOR IMMEDIATE RELEASE:
October 13, 2010

RALEIGH – The American Civil Liberties Union, the ACLU of North Carolina, and the ACLU of Georgia today filed lawsuits in federal courts in North Carolina and Georgia on behalf of Mark Lyttle, a U.S. citizen of Puerto Rican descent with mental disabilities who was wrongfully deported to Mexico and forced to endure over four months of living on the streets and in the shelters and prisons of Mexico, Honduras, Nicaragua and Guatemala.

“What happened to Mark Lyttle is unconscionable,” said Judy Rabinovitz, Deputy Director of the ACLU Immigrants’ Rights Project. “Our Constitution and our laws demand fair treatment for people with mental disabilities in any court, including immigration courts. Pushing Mr. Lyttle through proceedings that he clearly couldn’t understand and then deporting him was not only inhumane but a gross violation of his due process rights. The complete lack of concern for the well-being of a man who would have obvious difficulties surviving on his own is truly appalling. What he suffered shouldn’t happen to anyone regardless of citizenship status.”

Lyttle’s entanglement with immigration authorities began when he was about to be released from a North Carolina jail where he was serving a short sentence for inappropriately touching a worker’s backside in a halfway house that serves individuals with mental disorders. Despite having ample evidence that Lyttle was a U.S. citizen – including his social security number, the names of his parents, his sworn statements that he was born in the United States and criminal record checks – officials from the North Carolina Department of Correction referred him to Immigration and Customs Enforcement (ICE) as an undocumented immigrant whose country of birth was Mexico. Lyttle had never been to Mexico, shared no Mexican heritage, spoke no Spanish and did not claim to be from Mexico.

The state of North Carolina has an agreement with ICE requiring state officials to report all incarcerated individuals whom they believe were born in other countries. ICE began investigating Lyttle and sent him to the Stewart Detention Facility, an immigration detention center in Lumpkin, Georgia, where he spent six weeks.

Although ICE knew of Lyttle’s long and documented history of mental disabilities and noted he did not comprehend the investigation of his status, he was not offered legal assistance and was deported to Mexico.

“Mark Lyttle was born right here in Rowan County, North Carolina,” said Katy Parker, Legal Director for the ACLU of North Carolina Legal Foundation. “There was plenty of evidence indicating that fact, and with the slightest bit of effort, the government could have confirmed his U.S. citizenship instead of shipping this poor man off to a country where he didn’t even speak the language.”

Lyttle was left alone and penniless in Mexico and unable to communicate in Spanish. Mexican authorities sent him to Honduras, where he was imprisoned and faced with guards who threatened to shoot him. Honduran officials sent him to Guatemala and, eventually, he made his way to the U.S. Embassy in Guatemala City. Within a day, embassy officials contacted one of Lyttle’s three brothers at the military base where he was serving, leading to Lyttle being issued a U.S. passport. His brother wired him money, and Lyttle was soon on a flight to Atlanta. Upon Lyttle’s arrival, border officials, seeing his history of ICE investigations, held and questioned him for several hours before letting him go.

During this four-month ordeal, Lyttle was unable to take his medications to treat his mental disabilities and was subject to cycles of manic activity and depression. He is now living in Griffin, Georgia, where he is recovering and receiving medication for his mental health problems.

“I didn’t think what happened to my brother could ever happen in America. We’re supposed to be protecting people’s rights and freedoms here,” said David Lyttle, one of Mark Lyttle’s brothers and who is currently living in South Carolina. “Nothing can take back what he suffered, but I hope this lawsuit prevents other people from going through the same thing he did.”

The lawsuits, filed by the ACLU in conjunction with lawyers at Troutman Sanders in Georgia and McKinney & Justice in North Carolina, seek damages and injunctive relief for violations of Lyttle’s constitutional rights to due process and equal protection.

Copies of today’s lawsuits are posted online.

The widespread failure of the Department of Homeland Security and the Department of Justice to implement a system to identify immigration detainees who have severe mental disabilities and provide them assistance throughout the detention and court process was recently documented in a report jointly published by the ACLU and Human Rights Watch. The report can be found at: www.aclu.org/human-rights/deportation-default-mental-disability-unfair-hearings-and-indefinite-detention-us-immig

NC News: Early Voting Starts Thursday, October 14th

2010-10-13T07:35:00.002-04:00

Early Voting in North Carolina begins on Thursday, October 14th. We encourage you to take advantage of voting at Early Voting sites across North Carolina.

Here is the link to Early Voting Sites in North Carolina.

A reminder of your rights as a voter in North Carolina.

MY VOTING RIGHTS
As a voter with a disability I have the right to:
1) Not be denied my right due to a disability.
2) Vote if I am in line before the polls close.
3) Choose a person to help me, but this person cannot be my employer or an agent of my employer or union.
4) Be reassigned before the election to a site accessible to me.

WAYS TO VOTE
1) Voting inside the polling site…..usually accessible, but maybe not for all
2) Curbside voting….If you can get to the voting site, but can’t get into the building because of your disability, a poll worker can come to your vehicle.
3) Absentee Ballot by mail….Any registered voter is authorized to vote by mail using an absentee ballot.
4) Absentee One-Stop (No excuse)…Allows voters to vote in person ahead of the election by up to 19 days.
5) Satellite voting sites…Some counties establish a plan that allows voters with disabilities to vote at designated sites.

WHAT IF I HAVE TROUBLE
1) Laws protect your right to register and vote
2) Call the County Board of Elections and State Board of Elections
3) Call Disability Rights NC
4) You may always vote a provisional or contested ballot

Special Thanks to Disability Rights North Carolina for the Voting Rights information

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

2010-10-12T18:10:00.000-04:00

Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, & Substance Abuse Services
AGENDA
October 13, 2010 9:30 A.M.; Room 643, Legislative Office Building
Representative Verla Insko, Co-Chair, Presiding

9:30 Welcome and Opening Remarks
Senator Martin Nesbitt, Co-Chair
Representative Verla Insko, Co-Chair

9:30-10:00 Secretary's Remarks Lanier Cansler, Secretary
Department of Health and Human Services

10:00-10:15 Expenditures & Utilization Tracking Update Craigan Gray, M.D., State Medicaid Director
Division of Medical Assistance

10:15-11:00 SIS Assessment Tool Pilot Project Rose Burnett
(Implementation of Sec. 10.6 of Budget Bill) DD Project Manager, DMH/DD/SAS

11:00-11:30 Independent Assessments/MH Services
(Implementation of Sec. 10.36 of Budget Bill) Beth Melcher, Ph.D.
Asst. Secretary for MHDDSA Services Development

11:30-11:45 Update on Dorothea Dix Hospital &
Report on Operating Budget
(Sec. 10.10 of Budget Bill) Luckey Welsh
Director of State Operated Healthcare Facilities

11:45-12:45
Lunch

1:00-1:45 National Health Reform: Overview and Impact on MH/DD/SA Services Pam Silberman, JD, DrPH
President & CEO, NC Institute of Medicine
Publisher, NC Medical Journal

1:45-2:15 Implementation Update on CAP-MR/DD Tiered Waiver Rose Burnette
DD Project Manager, DMH/DD/SAS

2:15-2:45 LME Presentation on Youth Villages Transitional Living Program Sabrina Russell-Holloman, Utilization Management Supervisor, Guilford Center Behavioral Health and Disability Services

Mary Lee, Business Development Specialist, Transitional Living, Youth Villages

Annie Smith, State Director, Youth Villages

2:45-3:00 Analysis of Effectiveness of Single Stream Funding (S.L. 2009-191, Sec. 2) Steve Jordan
Director, DMH/DD/SAS

3:00 Closing Comments & Adjournment

Hill Report: NOD/Harris Survey-Disability Employment

2010-10-12T18:08:00.001-04:00

NOD News
Harris Interactive Survey: Largest Minority Group Falls Behind in Companies’ Attempts to Diversify
Kessler Foundation and National Organization on Disability Call on Employers to Hire Americans with Disabilities

NEW YORK, October 5, 2010 – A new survey sponsored by Kessler Foundation and National Organization on Disability (NOD) finds that although corporations recognize that hiring employees with disabilities is important, most are hiring very few of these job seekers and few are proactively making efforts to improve the employment environment. These results, from the Kessler Foundation/National Organization on Disability 2010 Survey of Employment of Americans with Disabilities conducted by Harris Interactive, are especially important given the focus on employment by media and government and with October recognized as National Disability Employment Awareness Month.

Data released in July 2010 from an earlier study, the Kessler Foundation/NOD Survey of Americans with Disabilities, found that little progress has been made in closing the employment gap between people with and without disabilities since the passage of the Americans with Disabilities Act in 1990. In fact, only 21 percent of people with disabilities, ages 18 to 64, reported that they are working either full or part-time, compared to 59 percent of people without disabilities.

From this latest survey, although 70 percent of corporations polled have diversity policies or programs in place, only two-thirds of those with programs include disability as a component. Only 18 percent of companies offer an education program aimed at integrating people with disabilities into the workplace. The low figures are particularly notable given that a majority of employers perceive the costs of hiring a person with a disability to be the same as hiring a person without a disability (62 percent).

Read More Here

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

2010-10-06T20:12:00.002-04:00

Notice: The Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Service will be meeting on Wednesday, October 13, 2010.

Here is the agenda for the next meeting. As always, we encourage you to attend this meeting or listen on line.

Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, & Substance Abuse Services
AGENDA
October 13, 2010 9:30 A.M.; Room 643, Legislative Office Building
Representative Verla Insko, Co-Chair, Presiding

9:30 Welcome and Opening Remarks
Senator Martin Nesbitt, Co-Chair
Representative Verla Insko, Co-Chair

9:30-10:00 Secretary's Remarks Lanier Cansler, Secretary
Department of Health and Human Services

10:00-10:15 Expenditures & Utilization Tracking Update Craigan Gray, M.D., State Medicaid Director
Division of Medical Assistance

10:15-11:00 SIS Assessment Tool Pilot Project Rose Burnett
(Implementation of Sec. 10.6 of Budget Bill) DD Project Manager, DMH/DD/SAS

11:00-11:30 Independent Assessments/MH Services
(Implementation of Sec. 10.36 of Budget Bill) Beth Melcher, Ph.D.
Asst. Secretary for MHDDSA Services Development

11:30-11:45 Update on Dorothea Dix Hospital &
Report on Operating Budget
(Sec. 10.10 of Budget Bill) Luckey Welsh
Director of State Operated Healthcare Facilities

11:45-12:45
Lunch

1:00-1:45 National Health Reform: Overview and Impact on MH/DD/SA Services Pam Silberman, JD, DrPH
President & CEO, NC Institute of Medicine
Publisher, NC Medical Journal

1:45-2:15 Implementation Update on CAP-MR/DD Tiered Waiver Rose Burnette
DD Project Manager, DMH/DD/SAS

2:15-2:45 LME Presentation on Youth Villages Transitional Living Program Sabrina Russell-Holloman, Utilization Management Supervisor, Guilford Center Behavioral Health and Disability Services

Mary Lee, Business Development Specialist, Transitional Living, Youth Villages

Annie Smith, State Director, Youth Villages

2:45-3:00 Analysis of Effectiveness of Single Stream Funding (S.L. 2009-191, Sec. 2) Steve Jordan
Director, DMH/DD/SAS

3:00 Closing Comments & Adjournment

Hill Report: President Obama Signs Rosa's Law

2010-10-05T16:13:00.003-04:00

BREAKING NEWS: Disability Scoop is reporting that President Barack Obama has signed "Rosa's Law"

Obama Signs Bill Replacing ‘Mental Retardation’ With ‘Intellectual Disability’
By MICHELLE DIAMENT
October 5, 2010 Text Size A A
President Barack Obama signed legislation Tuesday requiring the federal government to replace the term “mental retardation” with “intellectual disability” in many areas of government.
The measure known as Rosa’s Law was approved unanimously by Congress before receiving the go-ahead from the president with little fanfare this week.
Under the law, “mental retardation” and “mentally retarded” will be stripped from federal health, education and labor policy. “Intellectual disability” and “individual with an intellectual disability” will be inserted in their place. The rights of individuals with disabilities will remain the same.
“This is a really important step, particularly for the self-advocacy community,” said Peter Berns, CEO of The Arc, which lobbied heavily for Rosa’s Law. “Self-advocates have been working for many years to remove hurtful language and this takes our community one step closer.”
Even with the new law in effect, the terms will not be swapped out immediately. That’s because the change will be implemented gradually over the next several years as laws and documents are revised so that the alteration does not incur any cost.

Read more at Disability Scoop.

Hill Report: October Is Disability Employment Month-Presidential Proclamation

2010-10-04T08:30:00.000-04:00

Presidential Proclamation--National Disability Employment Awareness Month

As Americans, we understand employment and economic security are critical to fulfilling our hopes and aspirations. We also know we are stronger when our country and economy can benefit from the skills and talents of all our citizens. No individual in our Nation should face unnecessary barriers to success, and no American with a disability should be limited in his or her desire to work. During National Disability Employment Awareness Month, we renew our focus on improving employment opportunities and career pathways that lead to good jobs and sound economic futures for people with disabilities.

This year marks the 20th anniversary of the Americans with Disabilities Act (ADA), the landmark civil rights legislation that established a foundation of justice and equal opportunity for individuals with disabilities. In the two decades since its passage, much progress has been made. However, Americans with disabilities continue to be employed at a rate far below Americans without disabilities, and they are underrepresented in our Federal workforce.

My Administration is committed to ensuring people living with disabilities have fair access to jobs so they can contribute to our economy and realize their dreams. To help achieve this goal, I signed an Executive Order in July to increase Federal employment of individuals with disabilities. This directive requires Federal agencies to design model recruitment and hiring strategies for people with disabilities, and to implement programs to retain these public servants. To ensure transparency and accountability, agencies will report on their progress on hiring people with disabilities, and the Office of Personnel Management will post the results of agencies' efforts online for public evaluation. As the Nation's largest employer, the Federal Government can become a model employer by increasing employment across America of individuals with disabilities.

The 21st-century economy demands a highly educated workforce equipped with the technology and skills to maintain America's leadership in the global marketplace. Technology has changed the way we work, and the Federal Government is leveraging emerging, assistive, and other workplace technologies to improve the options available for everyone, including workers with disabilities. We must improve the accessibility of our workplaces and enable the collaboration and contributions of every employee, and that is why I look forward to signing into law the Twenty-First Century Communications and Video Accessibility Act of 2010. This legislation will greatly increase access to technology, with advances in areas such as closed captioning, delivery of emergency information, video description, and other advanced communications -- all essential tools for learning and working in today's technological society.

Individuals with disabilities are a vital and dynamic part of our Nation, and their contributions have impacted countless lives. People with disabilities bring immeasurable value to our workplaces, and we will continue to address the challenges to employment that must be overcome. This month, let us rededicate ourselves to fostering equal access and fair opportunity in our labor force, and to capitalizing on the talent, skills, and rich diversity of all our workers.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim October 2010 as National Disability Employment Awareness Month. I urge all Americans to embrace the unique value that individuals with disabilities bring to our workplaces and communities and to promote everyone's right to employment.

IN WITNESS WHEREOF, I have hereunto set my hand this first day of October, in the year of our Lord two thousand ten, and of the Independence of the United States of America the two hundred and thirty-fifth.

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

2010-09-30T14:33:00.001-04:00

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

2010-09-29T08:46:00.001-04:00

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

2010-09-27T19:05:00.003-04:00

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

2010-09-22T18:22:00.004-04:00

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

2010-09-22T07:14:00.001-04:00

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

2010-09-21T15:33:00.002-04:00

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

2010-09-20T08:18:00.002-04:00

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

2010-09-20T08:14:00.003-04:00

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

2010-09-13T10:03:00.002-04:00

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

2010-09-11T07:28:00.000-04:00

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

2010-09-07T07:49:00.001-04:00

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

2010-09-02T05:48:00.003-04:00

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

2010-08-31T08:04:00.002-04:00

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

2010-08-24T11:32:00.001-04:00

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

2010-08-20T17:34:00.003-04:00

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

2010-08-20T16:46:00.001-04:00

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

2010-08-20T14:19:00.002-04:00

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

2010-08-20T10:51:00.003-04:00

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

2010-08-18T14:30:00.002-04:00

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

2010-08-10T08:44:00.001-04:00

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

2010-08-05T13:06:00.001-04:00

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

2010-08-04T15:00:00.001-04:00

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

2010-08-04T10:21:00.002-04:00

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?

2010-08-02T20:16:00.001-04:00

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

2010-07-06T06:40:00.003-04:00

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

2010-07-02T10:01:00.003-04:00

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

2010-06-30T22:16:00.002-04:00

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

2010-06-30T07:06:00.003-04:00

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

2010-06-30T06:54:00.002-04:00

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

2010-06-29T15:58:00.002-04:00

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

2010-06-28T21:28:00.002-04:00

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

2010-06-28T17:55:00.001-04:00

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.

2010-06-28T14:15:00.004-04:00

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

2010-06-27T07:58:00.002-04:00

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

2010-06-25T11:45:00.002-04:00

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.

2010-06-22T06:39:00.001-04:00

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

2010-06-21T06:31:00.002-04:00

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

2010-06-16T06:08:00.000-04:00

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

2010-06-10T19:18:00.004-04:00

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

2010-06-10T06:53:00.002-04:00

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

2010-06-09T09:49:00.002-04:00

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

2010-06-08T18:10:00.007-04:00

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

2010-06-08T08:07:00.001-04:00

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

2010-06-07T19:14:00.002-04:00

Senate/House Budget Comparison:

Senate Only

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

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

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

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

Training in Facilities $534,795 R

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

Leadership Academy $250,000 NR

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

Special Olympics $100,000 NR

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

House Only

ALS Association $300,000 NR

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

Chapter of the ALS Association for services provided in North Carolina

House/Senate Conflicting Appropriation Amounts

Community Service Funds

Senate: $23,000,000 NR

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

House: $18,809,089 NR

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

NC Health Choice Enrollment

Senate: $6,500,000 R

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

House: $3,250,000 R

Provides additional State appropriations for Health Choice.

In-Home Personal Care Services

Senate: ($59,805,207) R

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

House: ($34,519,278) R

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

NCGA: Senate Vote to Not Concur with House Budget

2010-06-07T19:06:00.000-04:00

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