Saturday, April 30, 2011

Bill Update for Weeks of April 18 and April 25

HB 234, Juror Qualifications/Disabilities (Glazier, S. Stevens, Parfitt, Samuelson Sponsors). HB 234 seeks to amend the current Juror Qualifications statute to remove the ability to hear as a requirement to serve as a juror. It also seeks to amend the statute regarding Requests to be Excused from Jury Duty to allow potential jurors with a disability to request to be excused if the person feels that their disability could interfere with their ability to serve as a juror. It was signed by the Governor on April 19, Chaptered Session Law 2011 42.

HB 344, Tax Credits for Children with Disabilities (Stam, Randleman, Jordan and Jones Sponsors). The bill creates an individual income tax credit for families of children with disabilities who require special education and are attending a nonpublic school, in a public school at which tuition is charged, or homeschooled. It also creates a Fund for Special Education and Related Services. The bill received a favorable report from the House Education committee last week and will next be heard in the House Finance committee.

HB 397, DHHS Penalties and Remedies Revision (Lewis Sponsor). HB 397 seeks to amend facility penalty provisions under 122C, 131D and 131E to split Type A violations into Type A1 (violations that result in result in death or serious physical harm, abuse, neglect, or exploitation) and Type A2 violations (violations that result in substantial risk that death or serious physical harm, abuse, neglect, or exploitation will occur). The concerns that Disability Rights NC had with the bill were addressed and we do not oppose the bill. It received a favorable report from the House Judiciary A Committee, and will next be heard in House Finance.

HB 417, Extend Time for Site of Low/Moderate Income Housing (McGrady Sponsor). HB 417 seeks to extend the time, for tax purposes, that real property may be held by a non-profit organization as a future site for housing for individuals or families with low or moderate incomes fro m 5 to 10 years. It received a favorable report from the House Commerce committee and will next be heard in the House Finance committee.

HB 423, Enact First Evaluation Program (Hurley Sponsor); SB 437 (Hartsell Sponsor). HB 423 seeks to codify a practice that has been piloted that allows the Secretary to waive the requirements for a physician or eligible psychologist to perform the initial examination for involuntary commitment and substitute a licensed clinical social worker, a master's level psychiatric nurse, or a master's level certified clinical addictions specialist at the request of an LME. The House version was heard the week of 4/18 in the House Health and Human Services committee where the bill was amended to limit clinical addiction specialists to commitments involving substance abuse. The bill was scheduled to be heard in the full House last week but was pulled from the calendar and d referred back to the Health and Human Services committee.

HB 474, Protect Adult Care Home Residents (Weiss, Hollo, Farmer-Butterfield, Earle Sponsors). HB 474 proposes changes to Chapter 131D governing adult care homes to increase minimum continuing education, training, competency evaluation and inspection requirements for Adult Care Home medication aides, related to Infection Control Requirements. A committee substitute was approved by the House Health and Human Services committee and the full House last week.

HB 509, Exclusions from Licensure: Home Services (Hurley Sponsor). HB 509 seeks to allow people with disabilities who receive MH/DD/SA services to live together as roommates without their home being considered a facility for licensing purposes. The bill received a favorable report from House Health and Human Services and the full House this week. Thanks to Sponsor Representative Hurley!

HB 618, Streamline Oversight/DHHS Service Providers (Lewis, Hurley sponsors) (SB 525 was also filed). HB 618 seeks to streamline duplicate oversight of DHHS service providers. The bill was heard but not voted on in the House Health and Human Services committee the week of April 18. Because of the number of questions and concerns about this bill, the sponsor agreed to postpone a vote to allow the interested groups, including Disability Rights NC, to work out their differences.

HB 659, Capital Procedure/Severe Mental Disability (Stevens, Glazier, McGrady, Harrison Sponsors). This a Disability Rights NC agenda bill. It seeks to amend the capital trial, sentencing and postconviction procedures for a person with a severe mental disability to address the issue upfront in trial, and to remove the death penalty as the highest punishment if the individuals qualifies as a person with severe mental disability under the law. It also seeks to provide that Not Guilty by Reason of Insanity is not an available defense if prior alcohol or drug use are the sole cause of the psychosis. It received a favorable report from the House Judiciary B committee the week of April 18 and will next be heard by the House Appropriations committee.

HB 734, Require Photo ID/Food Stamps Program (Warren, Brown, Lewis, Moore Sponsors). HB 734 seeks to require DHHS to issue debit cards that contain photo identification on the card for participants in the Supplemental Food and Nutrition Program (SNAP).  A committee substitute was approved by the House Judiciary C subcommittee, and, will next be heard in Finance.

HB 736, Amend Law re: School Discipline (Langdon, Luebke, Daughtry, Lucas Sponsors). HB 736 seeks to make a number of changes to Chapter 115C regarding school discipline with the goal of keeping students in school. A committee substitute received a favorable report the week of April 18 and the bill was approved by the full House this week. As amended, the bill makes clear that the local board of education, in its discretion, may provide students an opportunity for a review or appeal of a short term suspension to the superintendent or local board of education. The bill now proceeds to the Senate.

HB 808, Revise Laws on Adult Care Homes (Burr Sponsor). HB 808 seeks to waive annual inspections of Adult Care Homes that achieve the highest rating, and to develop an informal dispute resolution procedure that allows Adult Care Homes to dispute cited inspection deficiencies. The intent of the department is to focus more time on the homes with more problems. A committee substitute received a favorable report from the House Health and Human Services committee, and passed 2d reading in the full House this week.

SB 33, Medical Liability Reforms (Rucho, Apodaca, Brown sponsors). SB 33 seeks to limit medical liability claims through several reforms including a higher standard for liability when providing emergency medical care, ordering bifurcation upon motion of any party, and limiting the amount of noneconomic damages that may be awarded. The bill was heard and voted on favorably in the full House the week of April 18. Last week, the Senate voted on whether to concur the House committee substitute, which failed. The House and Senate will now negotiate their differences in a conference committee.
SB 328, Report on Transfer of CAP-MR/DD UR to LMEs (Nesbitt Sponsor). HB 75 seeks to require a report of DHHS to the Legislative Oversight Committee on MH/DD/SAS on the implementation of Utilization Review by designated LMEs for services provided under the CAP-MR/DD program. The report is to include a cost comparison and a report on accountability measures used by the LMEs to ensure the accuracy of the decisions.  The bill received a favorable report from the Senate Mental Health committee, and will next be heard in Appropriations.

SB 334, Expand Inpatient Psychiatric Beds/Funds (Nesbitt Sponsor). SB 334 seeks $39 million for the expansion of local inpatient psychiatric beds or bed days, as recommended by the MH/DD/SAS Legislative Oversight Committee. The bill received a favorable report from Senate Mental Health, and will next be heard in Appropriations.

SB 335, Apply for TBI Medicaid Waiver (Nesbitt Sponsor). SB 335  directs the DHHS to apply for a 1915(c) Medicaid waiver, in consultation with the North Carolina Traumatic Brain Injury Advisory Council,  to permit persons who sustain traumatic brain injuries to access home and community based Medicaid services. The Department shall not submit the application to CMS unless the General Assembly identifies a source of funding sufficient to provide the match for this proposed waiver from State appropriations earmarked for persons with traumatic brain injury. The bill received a favorable report from Senate Mental Health, and will next be heard in Appropriations.

SB 401, ACH Pilot on Crisis Intervention Training (Bingham Sponsor). SB 401 directs the Division of MH/DD/SAS to coordinate a pilot program in 10 adult care homes identified as having a significant percentage of residents with a primary diagnosis of mental health problems and where crisis management has been a concern in the past to evaluate the effectiveness of crisis intervention training. It also directs the Division to consider modification of the current North Carolina Interventions (NCI) Prevention training to a one-day training program appropriate for adult care home staff, including personal care aides, medication aides, and supervisors employed by the participants in the pilot program. The bill is based on Recommendation 5.2 from the North Carolina Institute of Medicine Task Force on the Co Location of Different Populations in Adult Care Homes and as Recommended by the North Carolina Study Commission on Aging.  The bill received a favorable report from the Senate Mental Health committee and the full Senate last week.

SB 421, GAST Training Pilot (Bingham Sponsor). SB 421 directs the DHHS Division of MH/DD/SAS to establish a pilot training program using Geriatric/Adult Mental Health Specialty Teams to conduct training in Adult Care Homes on preventing the escalation of behaviors leading to crisis, based on a recommendation of the NC Institute of Medicine Task Force on the Co-Location of Different Populations in Adult Care Homes. It received a favorable report from the Senate Mental Health committee and the full Senate last week.

SB 474, Photo ID for Certain Controlled Substances (Apodaca, Hise Sponsors). SB 374 seeks to direct pharmacies to require photo identification prior to dispensing Schedule II Controlled Substances. Schedule II includes a number of drugs for pain relief, and amphetamine substances (like Adderall). A committee substitute that added some Schedule III substances was adopted by the Senate Judiciary I committee, and the bill was approved by the full Senate. It will next be heard in the House Judiciary committee.

SB 498, Modify Law re: Corporal Punishment (Pate, Purcell Sponsors). SB 498 seeks to amend the law related to corporal punishment of children in public schools to restrict corporal punishment only to students whose parent or guardian has stated in writing that corporal punishment may be administered on that student (an Opt-in). The bill received a favorable report from the Senate Education committee several weeks ago, but ran into some opposition from the NC Family Policy Council when it was set to be heard in the full Senate. The Family Policy Council, which is dedicated to the preservation of the family and traditional family values, objected to the opt-in procedure of the bill, which, oddly enough, gives parents the absolute right to decide whether their child will be subjected to corporal punishment. The bill is likely to proceed with an opt-out, instead of an opt-in for parents (i.e., if a parent does not respond on the form that is sent home about corporal punishment, the school will take that as agreement from the parent that their child may be subjected to corporal punishment.).

SB 607, Conform Medical Record Laws (Stein). SB 607 seeks to amend various sections in the General Statutes to make it easier to share currently protected health information. The bill as filed allows service providers to share confidential information to coordinate (which means the provision, coordination, or management of MH/DD/SA services and includes the referral of a client from one facility to another) to coordinate appropriate and effective care, treatment or habilitation of the client. Before making such disclosures, the provider shall inform the client that the facility may make such disclosures unless the client objects in writing. If the client objects in writing, the disclosures are prohibited. A covered entity receiving confidential information under this provision may use and disclose the information when necessary to conduct quality assessment and improvement activities or to coordinate appropriate and effective care, treatment, or habilitation of the client. This language was a compromise reached among the provider community, DHHS and advocates. However, despite an understanding on the compromise language, Community Care of North Carolina and the NC Medical Society lobbied Senator Stein to change the language to allow disclosure of confidential information for any HIPAA purpose, not just for the limited purposes of conducting quality assessment and improvement activities or to coordinate appropriate and effective care, treatment, or habilitation of the client. Despite the objections of Disability Rights NC, Senator Stein proceeded with the language proposed by CCNC and the Medical Society. There were comments on both sides in the committee – the focus of those seeking broader disclosure is simply to make it easier for physicians to share confidential information about patients. Disability Rights NC and NAMI NC spoke in favor of limiting purposes for disclosure on the grounds that broad disclosure could be detrimental to patients with mental health disabilities that unfortunately remain greatly stigmatizing, and could serve as a disincentive to patients to even seek treatment. The committee gave the bill a favorable report with the understanding that the sponsor would continue to work with us. However, as of right now, the bill is scheduled for Monday evening. Disability Rights NC continues to advocate for limited disclosure of protected mental health information.

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