January 28, 2011 Weekly Bill Update

Although we are only 2 days into the new session, several bills relevant to people with disabilities have already been filed.  If you click on the bill links below, it will take you to the page of the General Assembly website about the bill.  There you can view the full bill text, see a full list of co-sponsors, and keep track of the bill as it proceeds.

HB 2, Protect Health Care Freedom (Barnhart, Stam, Hollo, Murry sponsors). This bill seeks to prevent the implementation of the Affordable Care Act ("ACA", i.e., healthcare reform legislation) provision that mandates individual health insurance. It also mandates that the Attorney General shall either join or bring a lawsuit challenging this provision. This bill was filed on the first day and heard in the Judiciary I committee on the second day of the session. It will likely be voted upon in the full House next week. DRNC is opposed to this bill.  The removal of the individual mandate jeopardizes the pre-existing condition mandate, and undercuts the provisions of the ACA that will control costs and keep premiums affordable for everyone.


HB 4, Disapprove Closure of Dorothea Dix Hospital (Weiss, Ross, Jackson sponsors). This bill disapproves the closure of Dorothea Dix Hospital. It does not address where the funds to operate the hospital would be come from. The bill was filed on the first day of the session and was referred to the House Rules committee.

SB 8, No Cap on Number of Charter Schools (Stevens sponsor). This bill eliminates the existing cap of 100 charter schools. It was filed on Thursday in the Senate and has not yet been referred to a committee. DRNC will be following this bill carefully and advocating for language to protect children with disabilities from discrimination.

Stay tuned for bill updates next week!

Senate Committee Appointments and DRNC Legislative Agenda

On Wednesday, I posted the membership for House committees key to disability issues.  Here are the key Senate committees:

Appropriations/Base Budget
Co-chairs: Brunstetter, Hunt and Stevens; Vice chairs: Apodaca, Garrou; Members: Blake, Blue, Brock, Brown, Dannelly, East, Graham, Harrington, Hartsell, Jackson, Jones, Nesbitt, Pate, Rucho, Tucker, Walters.

Appropriations Subcommittee on Education
Co-chairs: Apodaca, Preston, Tillman; Members: Dannelly, Garrou, Rucho, Soucek.

Appropriations Subcommittee on Health and Human Services
Co-chairs: Bingham, Blake and Pate; Vice chair: Tucker; Members: Allran, D. Berger, Hartsell, Mansfield, Purcell, Rabon.

Appropriations Subcommittee on Justice and Public Safety
Co-chairs: Brown and Goolsby; Vice chairs: Jones and Soucek; Members: Clodfelter, East, Newton.


Education
Co-chairs: Preston, Soucek and Tillman; Vice chair: Apodaca; Members: Allran, Atwater, Brown, Dannelly, Daniel, Forrester, Garrou, Goolsby, Graham, Gunn, McKissick, Newton, Purcell, Robinson, Rucho, Stein, Stevens, White.

Health Care

Co-chair: Bingham, Blake and Pate; Vice chair: Forrester; Members: Allran, Atwater, D. Berger, Clary, Kinnaird, Mansfield, Meredith, Purcell, Rabon, Robinson, Rouzer, Rucho, Tucker.

Judiciary I
Chair: Brunstetter; Vice chair: Goolsby; Members: Apodaca, Brock, Brown, Clodfelter, Harrington, Jenkins, Mansfield, Nesbitt, Pate, Rouzer, Rucho, Soucek, Stevens, Tillman, Walters

Judiciary II
Co-chairs: Allran, Daniel and Newton; Members: D. Berger, Bingham, Blue, Clary, Davis, East, Forrester, Hartsell, Jones, Stein, Tucker, Vaughan.

Mental Health and Youth Services
Co-chair: Hartsell; Vice chairs: Allran and Tucker; Members: Bingham, Davis, Daniel, Forrester, Jackson, Jones, Kinnaird, Nesbitt, Purcell, Robinson.

Pensions/Retirement /Aging
Co-chairs: Apodaca, Hise; Vice chair: Meredith; Members: Atwater, Brock, Dannelly, Davis, Garrou, Harrington, Jenkins, Pate, Preston, Rucho, Stevens, Walters.


Additionally, click here to view the Disability Rights NC legislative agenda for the 2011 session.

The 2011 Session of the North Carolina Legislature

Lots going on this week with the North Carolina Legislature convening today.  As expected, Representative Thom Tillis was elected Speaker of the House and Senator Phil Berger was elected President pro tem in the Senate.

Remember that Senate and House calendars will be posted on the website, http://www.ncleg.net/, where you can also find information about who represents you.

House Committee Appointments of note:

Appropriations Subcommittee on Education: Representatives Hilton, Holloway; Chairs; Representatives Avila, Bell, Blackwell, Blust, L. Brown, Gill, Jeffus, Johnson, Lucas, McLawhorn, Michaux, Parmon, Pridgen, Sanderson, Stam.

Appropriations Subcommittee on Health and Human Services: Representatives Burr, Dollar; Chairs; Representatives Barnhart, Brisson, Current, Earle, Farmer-Butterfield, Hollo, Hurley, Insko, Jones, Murry, Parfitt.

Education: Representatives Blackwell, Holloway; Chairs; Representatives M. Alexander, Avila, Bell, Blust, Bryant, Carney, Cleveland, Cotham, Daughtry, Dixon, Dockham, Faison, Fisher, Gill, Gillespie, Glazier, Hager, Hall, Hilton, Horn, Iler, Jeffus, Johnson, Jones, Jordan, Killian, Langdon, Lucas, Luebke, McGee,
McLawhorn, Michaux, Parmon, Pridgen, Rapp, Rhyne, Ross, Sager, Shepard, Stam, Stevens, Tolson, Torbett, H. Warren, Wilkins.

Election Law: Representative Lewis; Chair; Representatives M. Alexander, Blust, L. Brown, R. Brown, Burr, Cotham, Current, Dixon, Faircloth, Fisher, Floyd, Harrison, Iler, Insko, Jones, Jordan, Justice, Killian, Martin, McLawhorn, Michaux, Mills, Mobley, Ross, Sager, Stam, Starnes, E. Warren, Weiss.

Health and Human Services: Representatives Current, Hollo; Chairs; Representatives Barnhart, Brisson, R. Brown, Brubaker, Burr, Cotham, Crawford, Dollar, Earle, Faircloth, Farmer-Butterfield, Howard, Hurley, Insko, Jackson, Lewis, McElraft, Murry, Pierce, Randleman, Steen, Wainwright, Weiss, Wray;

Health and Human Services Subcommittee on Mental Health: Representative Hurley; Chair; Representative Burr.
 
Judiciary: Representative Daughtry; Chair; Representatives Blackwell, Blust, Bordsen, Bradley, R. Brown, Bryant, Burr, Crawford, Faircloth, Faison, Glazier, Guice, Hackney, Haire, Hall, Harrison, Hilton, Howard, Ingle, Jackson, Jones, Jordan, Killian, Martin, McGrady, Michaux, Mills, Mobley, T. Moore, Pridgen, Randleman, Rhyne, Ross, Stam, Stevens, Weiss.
 
Judiciary Subcommittee on Civil Law: Representative Blust; Chair; Representatives Blackwell, Crawford, Daughtry, Faison, Hall, Jackson, Jordan, Killian, Mills, Pridgen, Ross.
 
Judiciary Subcommittee on Criminal Law: Representatives Stam, Stevens; Chairs; Representatives Bordsen, Bryant, Burr, Faircloth, Glazier, Guice, Haire, Hilton, Ingle, Martin, McGrady, Michaux.
 
Stay tuned for weekly updates on bills filed.

NC Joint Legislative Oversight Committee on MH/DD/SAS

The Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services convened at the Legislative Office Building on Wednesday, Jan. 19,2011. The LOC is charged with examining system-wide issues that affect the development, financing, administration, and delivery (including service quality) of mental health, developmental disabilities, and substance abuse services.

Discussion of Draft Recommendations
The committee discussed and voted on the 2010-2011 Draft Recommendations.  The majority of the draft recommendations relate to reports the committee would like from DHHS (on topics such as the TBI waiver, implementation of CABHA, deaths in facilities, etc.), but also includes a recommendation to appropriate an additional $10 million for local inpatient psychiatric beds, and the identification of funding for a BART step-down unit.  Additions to existing recommendations and new recommendations were discussed.

• Recomendation #6 relating to expansion of the 1915 (b)/(c) Medicaid Waiver raised discussion as to whether the State may separate out developmental disability services (i.e., the 1915(c) portion). The consensus was that this should be determined at a later date.
• Recommendation #8 relating to equitable allocation of resources for all persons with developmental disabilities raised a discussion as to whether to add permissive language to give DHHS discretion to expand the current two-tier structure into a greater number of tiers (the recommendation calls for the renewal of the 2 current tiers (the comprehensive and supports waivers) but not an expansion into additional tiers, as the committee has previously called for). Members discussed concern about delegating too much authority to DHHS, and how more tiers could ultimately increase the overall cost of services, so the recommendation remained as-is.
• The two new recommendations discussed were: 1. Request a report on clubhouses, more specifically service definitions, rates of reimbursement, etc. Sen. Kinnaird requested this recommendation, stating that its omission was an oversight pursuant to discussions at previous meetings. The motion for the addition of this recommendation passed upon a vote.  2. Request that if the Dorothea Dix property is sold, that the General Assembly consider placing the proceeds of the sale in the State’s Mental Health Trust Fund. Sen. Allran requested this recommendation. The motion for the addition of this recommendation failed upon a vote.

CABHA Update, Beth Melcher, Assistant Secretary for MH/DD/SAS Development, DHHS

• Handout here
• The temporary rules on CABHAs (Critical Access Behavioral Health Agency) were approved in December 2010, and the program structure took effect on Jan. 1, 2011.
• Over 600 agencies applied for CABHA certification in 2010, and 177 have been certified to deliver services.
• Although current data show that nearly all 100 counties in NC are served by a CABHA—particularly because many provide services across county lines—the Department of Health and Human Services will be assessing the distribution of CABHAs by county to identify any deficiencies.
• Other “next steps” will include monitoring the transition of individuals from non-CABHA agencies to CABHAs; reviewing the new model for regulatory compliance and fiscal stability; and conducting regional meetings with Local Management Entities (LMEs).

Local Management Entity Medicaid Utilization Review, Anna North of Eastpointe and Ellen Holliman of The Durham Center

• Handout here
• Legislation in 2008 mandated the return of Medicaid utilization review from ValueOptions, to LMEs.
• To date, CAP (Community Alternatives Program / Medicaid home and community based services waivers) utilization review has cost 15% less via The Durham Center and Eastpointe as compared to the rates that were paid to ValueOptions.
• Beginning Jan. 20, 2011, Eastpointe, The Durham Center, Crossroads LME and Pathways LME will be doing CAP MR/DD utilization review statewide.

Residential Options for Children with Intellectual / Developmental Disabilities Ages 0 – 6 years, Rose Burnette, a Project Manager in the Division of MH/DD/SAS

• Handout here
• Nearly 23,000 individuals with intellectual and developmental disabilities received services in FY2010 in NC. Approximately 5% (1,115) of those individuals were ages 0 – 6 years.
• 28 children ages 0 – 6 residing within Medicaid funded, ICF-MR (Intermediate Care Facility for People with Mental Retardation) facilities across the state. A typical child in this category has “significantly high and complex, chronic medical needs and intellectual disabilities” which exceed a family’s ability to care for the child within the family home.
• Another 27 children are residing in foster homes; 9 are residing in State or private funded residential facilities; and 1051 are receiving services in the family home (with 1 child receiving CAP-MR/DD home supports). 

Early Intervention Program for Children Ages 0 – 3, Deborah Carroll, Head of the Early Intervention Branch in the Division of Public Health

• Handout here
• The program serves children with existing or established risk for developmental disabilities or delays. Developmental delays can be cognitive, physical, socio-emotional, or relate to activities of daily living. Title V Maternal and Child Health Block Grant funding provided $21 million in funding last year. However, enrollment has been limited since 2006, so a child’s developmental delay must be “significant” versus “mild” or “moderate.” Nonetheless, more than 18,000 children were enrolled in FY2009-2010.
• Anyone can refer a child to the program. However, program staff then conducts a developmental evaluation. Children who do not qualify for the Intervention Program can be referred to local health department services. Children who receive services undergo therapies but do not take medications. Each county’s Children’s Developmental Services Agency must provide the necessary services (and services coordination, such as linking a family to Medicaid and WIC) for a qualifying child even if no qualified provider is accessible. Services are to be provided in the “natural environment” of the child’s home or daycare. However, no residential services are available (e.g., for the aforementioned 0-6 population institutionalized in an ICF-MR). Once a child is 2 and one half years of age, the Early Intervention Program develops a transition plan for the child to enter into special education in the public school preschool disability program.

Thanks to our volunteer attorney, Sarah Pfau, for attending the committee meeting and providing this summary.

National Deaf-Blind Equipment Distribution Program: NPRM was released January 14, 2011. Comments are due February 4, 2011 and reply comments are due February 14, 2011.

The 21st Century Communications and Video Accessibility Act of 2010 (CVAA) requires that the FCC establish a National Deaf-Blind Equipment Distribution Program (NDBEDP) to make telecommunications service, Internet access service, and advanced communications, including interexchange services and advanced telecommunications and information services, accessible by low income individuals who are deaf-blind. On January 14, 2011, the Commission released a Notice of Proposed Rulemaking (NPRM) to implement this deaf-blind equipment distribution program. Comments on this NPRM are due February 4, 2011, and reply comments are due February 14, 2011. This NPRM asks questions regarding how the Commission should set up such a program, consumer eligibility, covered equipment and related services, funding, oversight and reporting, logistics and division of responsibilities, and other considerations. Members of the public are encouraged to provide their feedback in response to the many questions raised in this proceeding.



FCC Chairman Genachowski released the following statement on this NPRM: The Twenty-First Century Communications and Video Accessibility Act was enacted to ensure that people with disabilities have access to today’s communications technologies and services. It is fitting that we begin implementing this law with these proposals to bring the benefits of modern communications to people with low incomes who are both deaf and blind. It is my hope that with access to Twenty-First Century communications services, these individuals will be able to participate more fully in the economic and civic life of our nation.


The Chairman’s statement can be found at: http://www.fcc.gov/Daily_Releases/Daily_Business/2011/db0114/FCC-11-3A2.doc

The Commission for MH/DD/SAS Advisory and Rules Committee meetings will be held January 27

The Commission for Mental Health, Developmental Disabilities and Substance Abuse Services (MH/DD/SAS) is a commission that reviews some of the MH/DD/SAS rules before they reach the Rules Review Commission, and also advises the DHHS Secretary on matters related to MH/DD/SAS. Their meetings are held at the Clarion Hotel State Capital, 320 Hillsborough Street, Raleigh, NC.



Agenda for the Commission for Mental Health, Developmental Disabilities and Substance Abuse Services Advisory Committee

Thursday, January 27, 2011, 9:30 am

9:30 – 9:55, Larry Pittman, Chairman, NC Commission for MH/DD/SAS, Advisory Committee

• Call to Order

• Moment of Reflection

• Ethics Statement

• Welcome and Introductions

• Approval of Minutes

• Subcommittee Guidance

10:00-11:30, Breakout Session for Subcommittees:

• CABHA

• Workforce Development Initiative

• Traumatic Brain Injury (TBI) – Veterans andMental Health, Developmental Disabilities and Substance Abuse Services

Agenda for the Commission for Mental Health, Developmental Disabilities and Substance Abuse Services Rules Committee Meeting
Thursday, January 27, 2011, 1:00 p.m.

Jerry Ratley, Chair, NC Commission for MH/DD/SAS, Rules Committee

• Call to Order

• Moment of Reflection

• Ethics Statement

• Welcome and Introductions

• Approval of Minutes


Stephanie Alexander, Chief, Mental Health Licensure Section, NC Division of Health Service Regulations

• Proposed Amendment of 10A NCAC 27G .0813 – Waiver of Licensure Rules

• Proposed Adoption of 10A NCAC 27G .0105 –General Definitions
Jerry Ratley, Betty Gardner, John Carbone

• Proposed Amendment of 10A NCAC 26D, NC Department of Correction Standards for Mental Health and Mental Retardation (DOC Response)

Public Comment


Adjournment

Statement of Mental Health America on the Tragedy in Arizona

Below is the statement of Mental Health America on the tragedy in Arizona.  Very well-said, I believe.  I sincerely hope that this latest tragedy leads to a thoughtful conversation about our mental health system (and please, please no more cuts to the services we have), rather than how to further curtail the rights of people with mental illness.

Statement of Mental Health America on the Tragedy in Arizona


Contact: Steve Vetzner, (703) 797-2588 or svetzner@mentalhealthamerica.net

ALEXANDRIA, Va. (January 10, 2011)—Mental Health America joins Americans in mourning the loss of those killed in Saturday’s tragic and senseless attack and expressing our wishes for the full recovery of Congresswoman Gabrielle Giffords and fellow citizens who were injured. Our thoughts and prayers are with the families and loved ones of those who lost their lives and everyone who is affected by these horrific events. And we join in applauding the brave actions of individuals who prevented greater harm.

It will likely take many days to understand the reasons and motivations behind this national tragedy. Many have pointed to mental health as an issue.

It must first be emphasized that people with mental health conditions are no more likely to be violent than the rest of the population. And we have science-based methods to successfully treat persons with even the most severe mental illnesses. A very small group of individuals with a specific type of mental health symptoms are at greater risk for violence if their symptoms are untreated.

At the same time, we must recognize that the nation’s mental health system is drastically under-funded and fails to provide Americans living with mental health conditions with the effective community-based mental health services they need. Sadly, in the current environment of strained state budgets, mental health services have been cut drastically just as demand for these critical services has risen dramatically.

It is also important that, as a community, we assist persons with signs and symptoms of mental illnesses to seek treatment. Although rare, when a person becomes so ill that he/she is a danger to themselves or others state laws provide a way to get them help even if they don’t believe that they need it. The best strategy, however, is to have an accessible system of care that is easy to use.

Science has not developed tools to predict reliably individuals at risk for violence. But we can reduce the small risk of violence in those with certain mental health conditions by investing in proven intensive, coordinated community-based mental health services and making certain that they can access these services.

We do not know if the mental health system failed in this situation or if there were missed opportunities or if effective treatment might have averted this tragedy.

We do hope that we can find answers and create solutions that prevent this from ever happening again.

Mental Health America (www.mentalhealthamerica.net) is the country's leading nonprofit dedicated to helping all people live mentally healthier lives. With our century of service to America and our more than 300 affiliates nationwide, we represent a national movement that promotes mental wellness for the health and well-being of the nation— everyday and in times of crisis.

Durham Museum of Life & Science Needs Volunteers with Disbilities

If you have never been to the Museum of Life & Science in Durham, it is a fantasic place.  As part of their efforts to be accessible to all, the Museum has chosen to be part of a national study on accessibility. They will have evaluators visiting the Museum in February and March 2011 to help plan for inclusive design. They are looking for ADULT MEMBERS with visual, hearing, physical and/or learning impairments who would be available to meet with the evaluators and tour the Museum. If you are interested, please contact Shawntel Landavazo at (919) 220-5429 x373 or email Shawntell@ncmls.org.  Great opportunity to help!

Happy New Year! Lots going on in North Carolina

There is a lot happening in Raleigh to get ready for the legislative session, which begins Wednesday, January 26:

• The General Assembly has a new website. The session database and membership lists for the House and Senate have been changed to reflect the new membership.  Go to the “Who Represents Me” section to determine who the legislators are for where you live.
• There is lots happening with the new leadership in the NC House and Senate - Senator Basnight, the long-time leader of the Senate is stepping down, Senator Berger and Representative Tillis, the new Senate and House leaders are hiring new staff, etc.  Get all the latest at the News & Observer's Under the Dome blog.
• House Speaker-elect Thom Tillis has also proposed to consolidate the number of House Committees. Click here to see the new committee list.
• The session hasn't even started, yet there is constant discussion about it. While the official budget shortfall prediction has risen to $3.7 billion, the Governor and legislative leaders remain steadfast in their opposition to any new revenue. At the recent Economic Forecast Forum, Charlie Perusse, the Governor’s Budget Director, Sen. Pete Brunstetter (incoming Appropriations Chair) and Rep. Harold Brubaker all reiterated that the budget would be balanced without new revenue. Furthermore, Senate and House leaders state that they are working together on a budget (as opposed to the old system in which each chamber takes a turn and then the budget is reconciled). This means that the budget process will move very quickly after the Governor releases her budget in mid-February. If you would like to influence the process, the time to take action is now! If you click here there is a sample message for the Governor from the Covenant with NC's Children, of which Disability Rights NC is a member.

Juvenile Justice Consolidation

In early December, Governor Perdue proposed to merge the Department of Juvenile Justice and Delinquency Prevention (DJJDP) with the Department of Corrections and the Department of Crime Control to create a new Department of Public Safety. While we understand the need to find efficiencies in government due to ongoing budget pressures, we have serious concerns about merging DJJDP with Corrections, and the potential for DJJDP to lose its focus on prevention and treatment.

Just prior to the holidays, Disability Rights NC, along with our key allies, sent a letter to Governor Perdue stating that if DJJDP must be consolidated, then it should be merged with the Department of Health and Human Services, so that it can maintain its focus on prevention and treatment. Click here to see a copy of the letter.

We also sent out a press release in coordination with this letter. Click here to see coverage from the News and Observer. Click here to see an editorial from the Winston-Salem Journal.