FCC reopens NPRM to refresh pending record on Closed Captioning

The FCC, via The Consumer Government Affairs Bureau, is seeking to refresh the record concerning standards for closed captioning that were stated in Notices of Proposed Rulemaking in 2005 and 2008. Due to advances in technology, the FCC hopes to gain a better understanding of the issues and how they relate to pending proceedings.  More than five years have passed since the Commission sought comment on several important matters relating to the quality and implementation of closed captioning of video programming, and a variety of changes in the closed captioning landscape warrant a refresh of the record created in response to that proceeding. For example, the benchmarks for 100% captioning of nonexempt new English and Spanish language programming have passed, the transition to digital television occurred on June 12, 2009, and advances in captioning technology and availability have occurred. The Bureau also believes that a refreshed record will help it to better understand the issues that were raised for comment in the 2008 Closed Captioning Declaratory Ruling, Order and NPRM. Because, in the 2008 Closed Captioning Declaratory Ruling, Order and NPRM, the Commission adopted requirements for video program distributors to make contact information available to consumers, and requirements concerning the process for filing and handling closed captioning complaints, the Commission does not seek to refresh the record with regard to those matters.

For more information about commenting, please refer to the Federal Register Notice here.  Comments were due on November 24, 2010 but Reply comments may be submitted on or before December 9, 2010.

Proposed State Budget Cuts

While we have a really long way to go in the budget process this year, the discussion of what to cut has begun.  Governor Perdue recently asked all state government departments to provide her with budget scenarios that include 5%, 10% and 15% cuts.  Budget documents are available on the TogetherNC website.  Below are some highlights.

Health and Human Services (HHS)

HHS proposed cuts of approximately $246 million, $402 million and $730 million from its $4.9 billion budget.  Please note that the proposed cuts I reviewed did not include any proposals to cut funding to the Division of Medical Assistance (DMA).  As DMA oversees all Medicaid funded services, this is a very big open question.

$135 million in proposed cuts to the Divisions of MH/DD/SAS and State Operated Healthcare Facilities which includes:

• $20+ million/$24+ million/$41+ million reductions to services provided statewide through contracts with LMEs, including reductions in LME Cross Area Service Program (CASP) funds.  The reduction was calculated on a pro rata basis excluding crisis services funding.
• $1.7 million reduction to LMEs for system management.
• $20 million/$26 million reduction to LME Systems Management - counties would pay a portion of the non-federal share in varying amounts depending on the size of the LME, with the percentage decreasing as LMEs become larger ending at 15%.  The purpose is to incentivize counties and LMEs to achieve economies of scale and participate in the 1915(b)/(c) managed care waivers.  The state does not pay separate LME Systems Management fees to LMEs participating in the waiver because administrative costs are paid as a percentage of the service funds.
• $523,638 reduction to LMEs to fund School Based Child and Family Teams.  This proposal does not eliminate the Child and Family Teams altogether, but eliminates additional funding to 12 LMEs to place school nurses and social workers in low-wealth schools. (DSS has a companion proposal to eliminate the LME funding).

$9 million in proposed cuts to the Division of Aging and Adult Services which includes:

• A reduction of $2 million to eliminate the the State Adult Protective Services (APS) Fund, which pays for APS social workers in 52 county departments of social services to carry out their duties, including evaluating reports of alleged abuse, neglect and exploitation of adults with disabilities.
• $875,000 reduction to eliminate the State Adult Care Home Specialist Fund which funds the state share (25%) for these specialists who help assure that adult care homes meet state licensing standards and provide care to meet the residents' needs.   
• $500,000/$2.4 million reduction to non-Medicaid community based services, including in-home personal care, in-home respite care, home delivered meals, and medical transportation.

$7.6 million in proposed cuts to the Division of Central Management and Support

$67 million in proposed cuts to the Division of Child Development which includes:

• $9.4 million/18.8 million/28.2 million reduction to Smart Start.
• $1.3 million reduction to More at Four.

$846,322 and $1.8 million in proposed cuts to the Division of Health Service Regulation which includes:

• Eliminating 21 vacant positions ($846,322).

$31 million in proposed cuts to the Division of Public Health which includes:

• $9 million/11 million/1.2 million reduction to School Health Services to eliminate School Nurse positions.

$11 million in proposed cuts to the Division of Social Services

$8 million in proposed cuts to the Division of Rehabilitation Services which includes:

• $2 million reduction to funding for basic support case services that assist individuals in obtaining and retaining employment.
• $284,502 reduction to eliminate the remaining recreational therapist positions within Independent Living Services.
• $1.7/3.9 million million reduction to aid and public assistance through Independent Living Services , which prevents institutionalization and assists with deinstitutionalization.

$2.5 million in proposed cuts to the Division of Services for the Blind, Deaf, and Hard of Hearing which includes:

• $1.3 million/419,456/838,911 reductions to case service funds in the Medical Eye Care Program.

Department of Public Instruction (DPI)

DPI proposed cuts of 5% and 10%, amounting to $396 million and $793 million in reductions, which include:

• The elimination of 69,524.5 classroom teachers ($239 million/292 million proposed reductions).
• $24 million/29 million reduction to Children with Special Needs (a 3.4%/4.2% reduction) - there is no detail, so we don't know if this is a per pupil reduction or reduction of particular programs.  There have been reductions in the past two years that were due to a declining number of children with special needs.
• $202 million/394 million reduction for Teacher Assistants (a 38% and 75% proposed reduction!).
• $4 million reduction to More at Four.
• 5 and 10% reductions to the Residential Schools ($1.6 million/3.3 million).

Department of Juvenile Justice and Delinquency Prevention (DJJDP)

DJJDP proposed cuts of $2.4 million which include:

• $1.3 million reduction in Clinical Services, including eliminating up to 3 Psychological Program Managers, a 10% and 15% reduction in psychological services contracts, and the closing of Camp Woodson.
• $265,447 reduction in Community Services, including elimination of funding to Project Challenge and the Juvenile Assessment Center, and reduction of the Community Services motor fleet/travel budget.
• $419,502 reduction for Education Services which will eliminate 6 educator positions.
• $265,428 reduction in Juvenile Court Services.
• $137,989 in Youth Development

Department of Corrections (DOC)

DOC proposed cuts of $19 million and $28 million which include:

• $2 million/2.1 million reductions to the Administrative Division, including the elimination of funding for Harriett's House, Our Children's Place, Summit House and Women at Risk.
• $4.4 million/5.2 million reductions to the Division of Alcoholism and Chemical Dependency Programs, which will eliminate Evergreen Substance Abuse Treatment Services and Mary Frances Substance Abuse Treatment Services.
• $600,943/776,258 reduction to the Division of Community Corrections.
• $12 million/20 million reductions to the Division of Prisons, including closing Haywood Correctional.

Again, this is just the beginning and we have a very long road to go with the budget, but this gives an indication of where the departments think the cuts should be made.

NC Commission for MH/DD/SAS Meeting on Thursday, November 18, 2010

The NC Commission for MH/DD/SAS met on Thursday, November 18, 2010.  The agenda for the meeting is posted on the Commission website here.

Luckey Welsh, Director of the NC Division of State Operated Healthcare Facilities (DSOHF) addressed the Commission:

• Funds have been allocated for education and training in facilities – doing an assessment throughout the facilities asking what needs are beyond what is already being done. Started doing specialized training for managers and supervisors.

• Residential Schools Transfer – 156 teachers, 8 schools. Need to make sure teachers have their licenses, evaluations. Kathy Roades from OES will work for DSOHF to oversee education in the state facilities (psych hospitals and DD Centers).

• Walter B Jones undergoing Joint Commission survey soon.

• Blackley moving into new building in January – a lot of difficulty getting completed.

• DD Centers – TRAC program at Murdoch has 6 beds. Waiting list 6-12.

• O’Berry converting from ICF-MR to SNF. 3d cottage renovation on hold.

• Long Leaf converted a nursing unit into “Main Street" - a grant funded project that provides the residents with a main street type environment.

• Whitaker did outstanding on Joint Commission survey and received accreditation.

• New Cherry schedule to open January 2013.

• Broughton groundbreaking still scheduled for Spring.

• JIRDC incident: in a particular cottage, there was an individual who was being investigated, thought incidents were accidents until someone came forward and said they weren’t accidents. Several people in the cottage knew what was going on. In last quarter, only 4 instances of physical abuse. Each dealt with swiftly with the zero tolerance policy.

• Insko visit to Dix – No safeguards, administration not informed, policies not followed. She was not removed from the hospital. She met with everyone she wanted to. The next day, 4 representatives, including Insko, toured the facility. Secretary met with the representatives then as well.

• Delays of Care – Mr. Welsh believes do not have enough beds. State closed 450 beds, community closed 200 beds. Demands increasing. Laura White spoke about the delays as well. With Dix closure, charged with maintaining capacity and to not increase delays. (Handout with average patients on delay) Not tracking number of people presenting to ERs. Hospitals are on delay almost every day, but not every unit – i.e., a geriatric might be admitted right away, so we don’t know # of people who present and are admitted right away. Average wait is 51 hours. Commission member Don Trorbrough spoke about how patients should be treated during their wait. Chaining someone to the bed is not the way a person should be treated. Magistrate education program started in Catawba to educate on options short of IVC to state hospitals. Also working with Mobile Crisis Teams to try and avoid in-patient at state hospital if appropriate. ERs feel hamstrung by EMTALA. They are collecting data from local ERs on who these folks are. 50-58% coming into ER have no connection to mental health system. City police approach differently than sheriffs. In some areas, MCTs are working with local law enforcement for back-up when they have safety concerns. Victoria Wit in Sandhills has an ER training on array of services, etc. LME should be contacted after 24 hours, and DMH should be called after 48 hours in ER (this started in past two months). Pitt has a 10 bed MR/MI diversion unit. DMH is checking up on treatment providers who are supposed to be first responders to ensure they are available 24/7.

• Laura White spoke about cost reduction matters at Dix – in the process of transferring current patients to Cherry and CRH, to be done by end of December. Forensic Minimum, child outpatient and outpatient clinical research program will remain on Dix campus. They started with patients in long-term unit – 11 CRH, 24 Cherry – all transferred by earlier this week. Transfers to Cherry over 6 weeks, in very deliberate manner. Transferring people with significant behavioral needs to CRH now. Sandhills and Wake admissions will stop to Dix on Dec 3 at 8 pm, rolls over to CRH. Folks on Dix admission unit will be discharged over the next two weeks. Anyone remaining on Dec 20 will be transferred to CRH. 99% of staff (all but 3) have been offered positions at CRH. There were a few supervisory positions where individuals weren’t offered the same job. Established a priority in hiring at all facilities. Cherry is hiring the most so far, don’t know total number, in 30 range. Our system will be stronger with highly qualified Dix staff in other hospitals.

Steve Jordan, Director of NC Division of MH/DD/SAS:

• CABHA – biggest driving issue for them right now. Transferring 19,000 people from non-CABHA to CABHA agencies. 8/31 deadline to have application processed to continue services after 12/31. 300 applications came in the last two days. Processed all but 20 of those. In September issued benchmarks for transition for those who did not qualify or did not apply. By 10/15, those agencies had to submit a transition plan to local LMEs. LMEs review for appropriateness, 77% deemed appropriate. Of those denied, some providers just moved everyone over to outpatient therapy. Over the whole process 900 applications processed for over 600 agencies (3 chances to get attestation letter through desk review). 20 agencies still under consideration.

o There was a question from a member from Cumberland County - only 1 CABHA showing approved in Cumberland County.  Jordan said 96 now approved statewide – 4 now approved in Cumberland County (can be satellite offices of CABHA HQ’d elsewhere). Cumberland is well positioned because just went through the major transition with all of their level iii and iv group homes.
• 1915 (b)/(c) waivers – Mecklenburg has a 1 year extension. Looking to see if any other programs interested in going forward sooner. Need to establish momentum and move these forward. Using Mercer as external review to set tasks and timeline for Western Highlands.

• Budget - At DMH, each 5% cut = 25 mil in state services. 15% cut = $75 mil less in state services. Even if optional mental cut, DMH still responsible for serving all those cut from Medicaid. Starting to look at total system redesign, talking to other states. There are workgroups being held to determine what the core services need to be statewide. Any money that comes out of facilities will disappear, it won’t go to the community. Commitment to keep community crisis on the table. We must see collaboration to get through this.

• Corne gave a speech about Olmstead and ADA pushing people into least restrictive environment. Push to put person into their own home and that is not sustainable (his opinion). The system doesn’t have control over because federal government pushing this. There will likely be a lot of lawsuits. Steve responded that from the federal level, not having enough money to do it is not the answer.

Waiver Requests:

• 10A NCAC 27E .0107 Training on Alts to Restrictive Interventions – Rule addresses staff competencies for alternatives. They are asking that licensed professionals attest to their competency and not have to go through the training. The reasoning is that licensed individuals have to adhere to requirements of their licensure boards.  A thorough discussion ensued among the members of the Commission.  Members made different points and had differing views of the matter: some said that licensed professionals are not taught in a graduate program how to physically manage behavior; there is nothing in the attestation to say that the person’s training addresses restrictive interventions, anything to ensure that the professional is doing this by free choice – need to include documentation. John Owen moved to not approve waiver – motion failed. 2d motion – waiver approved. Copy of license, training certificates will be requested as attachments to the attestation.

• Lynn Jones, oversees DWI services for state – they authorize private providers to provide DWI services – want more time to review applications. Now only 20 business days, asking for 60 business days (got a waiver in May); it’s on the draft rules list but hasn’t gone to public comment yet, so asking for an extension of May waiver. # of applicants increasing – a lot of CABHA applicants and those not approved by CABHAs. Waiver granted.

Rules Committee:

• No October meeting. Prison rules sent over to DOC for review, done pursuant to G.S. 148-19. They got a response just this morning.

• 4 rules up for repeal – 27G .2200 withdrawn because of transitioning concerns for these facilities.

Advisory Committee

• Report on meeting held in October – CABHA, workforce development, veterans services with focus on TBI.

Rules to be Repealed, Amanda Reeder:

• 10A NCAC 27B .0600 Early Childhood Intervention Services for Children with or at risk of developmental delays, developmental disabilities or Atypical Development and their Families – passed in 1979. Rulemaking authority transferred to Div of Public Health, which has already issued rules related to these services. This repeal shouldn’t affect any services. Motion to repeal passed.

• 10A NCAC 27G .2400 Developmental Day Services for Children With or At Risk for Developmental Delays, developmental disabilities or Atypical Development and their Families. S.L. in 2009 amended authority – rules given to child care commission. They published rules effective July 1, 2010. Child Care Commission coordinated with DPI and DMH to draft. Motion to repeal passed.

• 10A NCAC 27G .2500 Childhood Intervention Services for Children with or at risk of developmental delays, developmental disabilities or Atypical Development and their Families. Motion to Repeal Passed.
Marcus Lodge, AG’s Office re Governor’s EO 70 re Rules Modification and Improvement

• Office of State Budget and Management already reviewing current rules and should be inviting public comment soon – the web portal has been established. OSBM will review comments as they come in and then send out to the agencies. Agencies will do a report each year.

• For new rules, OSBM will look at new rules as well to make sure cost benefit analysis done correctly, timely, etc. (all before publication).

Tracy Hayes, DMA AG, CABHA Rules Authority

• State Plan defines optional services, all CABHA services are optional.

• S.L. to implement state plan amendments give authority to issue temporary rules

• Reviewing comments now and will submit rules to RRC

Rule Update, Denise Baker:
• Provider endorsement rules pending for quite some time – initially the Secretary had rulemaking authority, then went to the Commission. Rules have undergone a number of changes. It is now pending (suspended) further revisions to the policy. Policy is in the final version so rulemaking should resume soon.

• DOC rules – DOC gave comments today. Next step should be January Rule Committee meeting to consider DOC comments.

• NCI QA rule – objected to by RRC.

• Several rules in fiscal note process

• Rule related to electronic supervision – waiting for new Medical director to draft.

• TBI rules – pending development by content experts – maybe some language will be generated by the advisory subcommittee.

• Smoking rule expired because it has been more than a year. The pilot study is nearing end – data collected and now analyzing. Commission will need to decide if they want to resume work on the rule.

North Carolina Senate Leadership

The Senate Republican Caucus has nominated Sen. Phil Berger as its candidate for Senate President Pro Tem, and has chosen Sen. Harry Brown as Majority Leader.

Disability Rights NC Opposes Proposed Community College Change to Admissions

Back in September, the State Board of Community Colleges published proposed changes to the rule related to admissions. The proposed language would allow community colleges to adopt policies refusing admission "if it is necessary to protect the health or safety of the applicant or other individuals."  The proposed language does not detail how such a determination will be made, nor does it mandate notice and appeal of the decision by the applicant.  In response, Disability Rights NC, along with the ACLU of North Carolina, the Arc of North Carolina, the Autism Society of North Carolina, and the National MS Society in NC, filed written comments and commented in person at a public hearing to voice our opposition to the proposed rule amendment.

We have grave concerns that the proposed language runs afoul of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act (Section 504). Additionally, we object to the lack of procedural protections provided.  Our full comments are available on our website here. 

New information available online for the 2010 ADA Standards for Accessible Design

The Department of Justice has assembled an official online version of the 2010 ADA Standards for Accessible Design (2010 Standards) to bring together the information in one easy-to-access location. You will remember that the Department of Justice recently revised the Title II and III regulations (published in the September 15, 2010 Federal Register).
Remember that if the start date for construction is on or after March 15, 2012, all newly constructed or altered State and local government facilities must comply with the 2010 Standards.

Before that date, the 1991 Standards (without the elevator exemption), the UFAS, or the 2010 Standards may be used for such projects when the start of construction commences on or after September 15, 2010.

For more information about the New ADA Title II and III Regulations and these ADA Design Standards, the archived version of the Access Board and DOJ joint Webinar held on September 2, 2010 has finally been posted at: http://accessibilityonline.org/Archives/index.php?type=transcript&id=2010-09-02&app=4

Notes from the MH/DD/SAS Legislative Oversight Committee Last Week

The Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities and Substance Abuse Services met last Tuesday, November 9th.  Co-chair Representative Insko presided over the committee meeting.  Her senate co-chair, Senator Nesbitt, was absent.  All of the handouts from the meeting are available on the committee website here.   Highlights from the meeting are below.

Secretary’s Comments

Secretary Cansler gave an update on the budget and the closure of Dix (very similar to those made to the Governmental Operations subcommittee - see previous post here). He discussed the Dix closure plan (available here) which was provided to all of the members the week before. He also talked about expanding the 1915 (b)/(c)waivers and measures the department will be seeking in the coming session. Mecklenburg LME will be delaying their implementation of the 1915(b)/(c) waiver by a year. Smokey LME is interested in pursuing the (b)/(c) waiver as well. He also noted that counties are still interested in joining PBH but the concerns about non-contiguous counties joining as one LME remain.

Expenditures and Utilization Tracking Update

The handout is on the website here.  Of particular note, Intensive In-Home for children is up, Day Treatment for children is down, Multisystemic Therapy is up, Community Support Team is down 28%, Assertive Community Treatment Team is up, Psychosocial Rehabilitation is up (200 more adults per month),  I/DD Targeted Case Management is down (CAP and non-waiver).

LME Presentation on TASC (Treatment Alternatives for Safer Communities)

There is a handout on website here.  East Carolina Behavioral Health presented.  The program operates under a Memorandum of Agreement between DHHS, the Department of Corrections and the Administrative Office of the Courts regarding the offender management model to ensure all agencies are connected.

Three-Way Contracts Update

The handout is on the website here.  Of particular note: The three-way contract beds are paid at a bundled rate of $750/day, which compares to about $1100-1200/day in state hospitals.  The hospitals with these contracts have  priority in transferring patients to state hospitals.  The total funding for these contracts is now a little over $29 million.  This is helping to stop the trend of closing community inpatient beds.  The LME Contract Responsibilities include authorization of admissions, collecting patient data, facilitate discharge planning, and paying hospitals.  Last year 100% of the funding allocated was used – 26,829 bed days purchased, 98 beds across the state. 

There are 20 contracts with 1 pending currently, added Pitt Memorial, Western Highlands did not renew 1 contract because of low utilization.  They needed to put additional money into existing contracts this year because of utilization, projecting 38,829 bed days, projected beds at 75% utilization=142.  The handout shows allocation by hospital and region. 

State hospital stays of 7 days or less have decreased to 27% of total (in part because of reduction in admissions).
At the start, 22 LMEs had these contracts without the state contract and funding.  There is a need to shore up these relationships as well. There is still $13-14 million in LME funded contracts, Mecklenburg being a good example (they use county funds).
ICF-MR Cost Analysis and Comparison with CAP-MR/DD Services

The handout is on the website here.  DMH/DD/SAS Director Steve Jordan presented a comparison of NC's ICF-MR services which include the state developmental centers (3), community ICF-MRs (327) and CAP-MR/DD services offered statewide.  Of particular note:

• Must be 18 years or older to be admitted to developmental center except for time-limited programs for children
• Average of 1517 people served in state DD Centers last year
• In NC, 30% of recipients live in ICF-MRs, 15% nationally
• 70% in waiver in NC, 85% nationally
• The handout details the total expenditures in state, community ICF-MRs and waiver services and cost per recipient (includes soc security, etc.) – the level of acuity in state facilities varies – generally those recipients are older, profound, feeding tubes, partial or total assistance with dressing, and nonverbal.
• Tennessee is going to close a large DD Center – moving people into community ICF-MRs

Update on CAP-MR/DD Tiered Waivers and Waitlist

The handout is on the website here.  Rose Burnette provided a general update on the status of the CAP-MR/DD waivers.  The Comprehensive Waiver is now serving 9798 and the supports waiver is serving 853 recipients.  Last year NC spent $493 mil in waiver services and $112 mil in other Medicaid services for Comprehensive Waiver recipients; and about $2.5 mil in waiver services and about $2.5 mil in other Medicaid services for supports waiver recipients.
With regard to the support waiver, they are doing trainings on the supports waiver this month.  They are estimating serving 126 participants on self- direction – these costs are outside of the waiver costs and are not in individual budget, (case management outside of waiver as well because it is Medicaid funded and not a waiver service) average cost $4000 per participant.

They are planning major revisions to the comprehensive waiver. They want to create a new Community Intensive Waiver – for those with the highest behavioral and medical supports needs. There will not be banding within a waiver – need to have a very specific plan for determining need and level of care within a band. They will have stakeholder workgroup meetings and then larger public forums to seek input.  The plan is to submit the new waivers in March or April to get approved in time for implementation (expire 11-1-11).

Waiting List Update: 8191 people are potentially eligible for CAP-MR/DD: 4,481 people waiting for residential (independent, group home); 4800 not receiving any service; 1785 waiting for support to work; people in Adult Care Homes may be on this list.  In the short term they continue to use a spreadsheet.  They are evaluating the feasibility of a web-based solution, and are meeting next month with LME IT staff to talk about possibilities. 

Res Supports Level V Update: expected staffing is 1:1 24 hours per day, plus specific experience and supervision;  PAG reviewed twice, last time in October; will be posted for 45 day public comment, review and revise as needed, hoping to implement early next year.

Find out who is representing you!

       Due to the results of last week’s election, North Carolina’s General Assembly has changed. It is important to remain aware of who your representatives are so, your voice can be heard. You can find out who will be representing you  by using the following link, http://www.ncga.state.nc.us/GIS/RandR07/Representation.html

Changes at the Legislature Next Year, But For Now We Keep On Rolling

Unless you are really good at staying away from all media (in which case you probably won't be reading this), you know that we are going to see a change in leadership at the North Carolina General Assembly next year.  The Republican party will now hold a majority in the House and the Senate (the Democrats have long held a majority in both chambers).  For people with disabilities, I believe change is opportunity.  The leadership that has eviscerated mental health services and kept the system for people with developmental disabilities in constant flux no longer holds power.  We have a real opportunity to put forth cost effective solutions that will lead to better lives for all people with disabilities in North Carolina.

But, for now, we keep on rolling with the current members and committees until the new regime is sworn in.  So, as an FYI, here is the agenda for next week's MH/DD/SAS Legislative Oversight Committee meeting.  Remember, audio is available through the legislature's website, ncleg.net.
 
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

North Carolina Legislative Briefings Coming to a Location Near You!

GET READY FOR 2011 at a Legislative Briefing by local legislators and staff from the NC Budget & Tax Center, NC Justice Center and United Way of North Carolina. Hot topics on the agenda include:

• The impact of the Great Recession on nonprofits and working families
• The state of North Carolina’s budget and projections for recovery
• Updates on key state programs including our education system and health and human services programs that support low and moderate-income families such as child care subsidies and health insurance.

Using your voice to make a difference in the issues you care most about.

Legislative Briefings will take place in:

Asheville, Chapel Hill, Charlotte, Fayetteville, Greensboro, Hickory, Raleigh, and Wilmington

Events begin November 15 and run through December 1

Raleigh event in January 2011

Visit http://www.unitedwaync.org/calendar.php for a complete list of events and to RSVP.

REMINDER!

Don't forget to VOTE tomorrow, Tuesday November, 2, 2010 for the mid-term elections. It's important that the voice of everyone in North Carolina is heard.   

 If you experience any difficulties while voting please call Disability Rights North Carolina at (919) 856-2195.

                                                 OR

Election Protection at 1-866-OUR-VOTE (687-8683)