April 13 Joint HHS Appropriations Meeting

Legislators are back in Raleigh in advance of the 2010 short session to begin discussions on the budget. Because of the state of the economy, NC is again facing a budget shortfall. So far, there is no talk of a balanced approach to close this gap and still maintain public structures. So we are looking at cuts, cuts, and more cuts.

Today, DHHS presented options for 3%, 5% and 7% cuts from the agency's budget. Secretary Cansler made it clear that these are options to make the cuts - not recommendations. However you put it, these cuts will be disasterous for people with disabilities.

There are 53 options on the list - I won't list them all here. Email me if you would like the whole list. Of particular note:
• Change State Participation in State Adult Care Home Specialist Fund: Reduces state portion of funding for staff at county DSS to monitor Adult Care Homes to assure that state licensure standards are being met and to investigate complaints about inadequate care.
• Reduced funding to counties for foster care/adoption, child protective services,and Adult Care Home Case Management Services.

• Elimination of Medicaid Services for Adults:
o Dental
o Optical Supplies
o Chiropractic
o Optical
o - Podiatry (except services relative to diabetes complications and certain vascular diseases)
o DD Case Management for Adults (except for CAP-MR/DD case management)
o Private Duty Nursing
o HIV Case Management
o Personal Care Services
o Case Management FSO - proposal to eliminate services provided by social workers under this programs which is 100% FEDERALLY funded

• Shift portion of LME systems management cost to counties, depending on the size of the LME (to incentivize counties and LMEs to achieve economies of scale and to "become prepared" to participate in 1915 Medicaid waivers)
• Close Wright School (effective Jan. 1 , 2011)
• Eliminate the Jails and Detention section from the Division of Health Services Regulation
• Consolidate responsibility for licensing facilities under G.S. 122C (consolidate endorsement and licensure efforts of DMH, DHSR and LMEs)
• Eliminate 8 recreational therapist positions in the Independent Living program in the Division of VR
• Reduce aid and public assistance within the Indpendent Living program:VR has instituted a priority of services plan.

The majority of the cuts proposed are to Medicaid-funded services, which are predominantly federally funded with a state match. These reductions to the Medicaid program would result in a loss of $450 million in federal funds coming in to North Carolina.

This is just the beginning . . . so stay tuned.