More on House Health and Human Services and Education Appropriations Proposals

Here is a really brief rundown of the special provisions from Health and Human Services (special provisions are the narrative that go along with the line items) and Education. A summary of Justice and Public Safety and relevant provisions from any other budget subcommittee will be posted later.  Appropriations subcommittees will be meeting next week to consider amendments and vote on the proposals.

Health and Human Services Special Provisions

• Mental Health Changes: leaves $29 mil in for local inpatient psychiatric beds; $5.7 mil to support 30 mobile crisis teams
• MH/DD/SAS Healthcare Information System Project: DHHS may use funds to continue to develop and implement a health care information system for state institutions operated by the Division of MH/DD/SAS.
• MH/DD/SAS Community Services funds: Big cuts, prohibition on state funded services for all Medicaid recipients (not just CAP-MR/DD) and copayments for state funded services: $20 mil cut to community service funding; LMEs prohibited from using community services (i.e., state or IPRS) funds for any Medicaid recipients' services, except for residential support services; and Division must develop a set of standardized covered benefits for recipients of state funds; copayment for all mh/dd/sa services based on medicaid copayment rates; reduce the funding for community services funds by additional $25 mil to be allocated among LMEs based on their fund balances ($209 mil in fund balances)
• Consolidation of Forensice Health Care at Dix: RFP to consolidate forensic hospital care on the Dix campus.
• DHHS Position Eliminations: eliminate 250 FTE positions, or $6.5 mil in state funds
• Study DHHS Regulatory Functions: Directs DHHS to study all regulatory functions performed by each division, with recommendations by January 30, 2012.  DHHS is directed to develop a plan but not implement or consolidate except as directed by the legislature.
• Reduce funding for nonprofit organizations: $5 mil reduction with instruction to minimize reductions to funds allocated to nonprofit organizations for the provision of direct services and shall not reduce funds allocated to nonprofit organizations to pay for direct services to individuals with developmental disabilities
• Authorizes DMA to take certain steps to make budget reductions: PCS provisions appears to be the same as last year (pages 56-59); MH Residential section (pages 61-62) incorporates changes from HB 377, supported by Disability Rights NC; Change to medicaid rate reductions section - adds adult care homes services to list of services protected from cuts (others are federally qualified health clinics, rural health centers, state institutions, hospital outpatient and pharmacies)
• Medicaid Appeals: Unfortunately, it is still not clear what changes are being proposed to the Medicaid appeals process.  There are 2 versions included in the Special Provisions starting at page 75 and we have not been able to sort out which version is actually being proposed.  So stay tuned.

Education
The Special Provisions are posted here and more handouts from the subcommittee meetings this week are available through the links here.

• The proposed Special Provision to accompany the $1 mil proposed allocation to study education reform in NC starts on page 2.  Included in the items to study is reducing the teacher:student ratio to 1:15 in first through third grade and transition from high school.
• The Special Provision regarding funding for students with disabilities has not changed.  This is a relief as this was an option discussed in committee.
• A Special Provision starting on page 21 removes the requirement in statute for school improvement and safe school plans.
• In the community college section, waiver of tuition and fees will no longer be included for the following: clients of sheltered workshops, clients of adult developmental activity programs, students in Health and Human Services development programs, and juveniles committed to the Department of Juvenile Justice, or prison inmates (although the Community Colleges shall transfer funds to the Department of Correction for curriculum and continuing education instruction, projected to result in a 43% reduction in the number of courses provided to prisoners).