Friday, May 27, 2011

Bill Update for the Week of May 23

Legislation With Activity This Week:

HB 115, North Carolina Health Benefit Exchange Act (Dockham, Brubaker, Wray, Murry Sponsors). HB 115 seeks to establish a Health Benefit Exchange to make available qualified health benefit plans beginning in 2014. This bill creates a version of the exchange that is governed by a board that includes insurers as voting members and is lacking in consumer protections. HB 115 passed the House this week with bipartisan support in an 83-34 vote. An amendment added to the bill adds language regarding the necessity of a conflict of interest policy but still allows current insurance company employees to serve on the board. The bill will now be referred to a Senate committee.




HB 188, Taxpayer Bill of Rights (Blust, Killian, Holloway, Dollar Sponsors). The bill seeks a constitutional amendment that would limit state spending to population growth plus inflation. Even though health care and other costs are increasing much faster than the overall inflation rate, the state could not adjust its spending to keep pace, which would result in massive cuts to healthcare and support services. HB 188 was heard but not voted on in the Judiciary A committee this week. The Treasurer’s office spoke against the bill, along with the Justice Center, but broad public comment in opposition was not allowed.



HB 233, Department of Correction/Ex-Offenders (Pierce, Bryant, M. Alexander, Frye Sponsors). This bill was a recommendation of the Joint Select Committee on Ex Offender Reintegration into Society. HB 233 designates the Department of Correction (DOC), Office of Research and Planning (ORP), as the single State agency responsible for the coordination and implementation of ex-offender reentry policy initiatives, including the StreetSafe Task Force, the Justice Reinvestment Initiative of the Council of State Governments (CSG), and the recommendations of the Joint Select Committee on Ex Offender Reintegration into Society. HB 233 received a favorable report from the House Government committee this week. It will next be voted upon by the full House.



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. The House concurred in the Senate committee substitute this week and it now proceeds to the Governor for her signature.



HB 618, Streamline Oversight/DHHS Service Providers (Lewis and Hurley Sponsors). HB 618 seeks to streamline duplicate oversight of DHHS service providers through recommendations of a task force that would include Disability Rights NC. The bill was scheduled for a vote in the full House this week but was withdrawn from the calendar and re-referred to the House Appropriations committee.



HB 623, Eliminate Agency Final Decision Authority (McCormick, Stevens, Cleveland, Glazier Sponsors). HB 623 would remove final decision making authority from agencies in contested cases under Chapter 150B, including Medicaid appeals. HB 623 passed the full House this week after 2 amendments were made on the floor. One amendment addressed Article 3A hearing procedures (which governs “other” administrative hearings regarding agencies like the department of insurance, the building code council and the banking commission). The second amendment added language to the bill directing DHHS to seek a waiver from the single state agency requirements, which will ensure that the Medicaid appeals process continues to comply with federal law and CMS requirements.



HB 656, Photo ID for Certain Controlled Substances (Guice, Ingle, Faircloth Sponsors). HB 656 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, as well as any drug that contains amphetamine (like Adderall). A committee substitute received a favorable report from the House Judiciary B committee this week.



HB 823, Governance of the Dep’t of Public Instruction (Holloway, Hilton, Brubaker, Blackwell Sponsors). The legislation proposes a constitutional amendment that voters would decide in 2012. It would make the state superintendent of schools a voting member of the State Board of Education and give the House and Senate appointments to the board, among other changes. The bill, approved in a 106-10 vote, now heads to the Senate.



SB 316, Additional Section 1915 Medicaid Waiver Sites (Hartsell Sponsor). SB 316 authorizes DHHS to allow additional 1915 (b)/(c) Medicaid waiver sites and to allow third-party billing for state facilities. This would allow further expansion of 1915(b)/(c) waivers beyond PBH, Mecklenburg and Western Highlands, without legislative approval. The Senate concurred with the House amendment this week and the bill now proceeds to the Governor.



SB 512, Adult Day Care/Overnight Respite Program (Clary). SB 512 directs the Department of Health and Human Services to conduct a pilot program to assess the provision of overnight respite services in adult day care programs. The bill received a favorable report from the House Health and Human Services committee this week, as well as approval from the full House, and ratification by the Senate. It now proceeds to the Governor for her signature.



Coming Up Next Week:



HB 916, Statewide Expansion of 1915(b)/(c) Waiver (Barnhart, Burr, Insko Sponsors). HB 916 is scheduled to be heard in the House Health and Human Services committee on Tuesday at 10 am. HB 916 seeks to have the waiver statewide by July 1, 2013, and sets out specific requirements for the expansion of this managed care behavioral health Medicaid waiver: accountability for the development of a local system that ensures easy access to care, availability and delivery of necessary services, and continuity of care; fidelity to the PBH model; designate entities to manage the waiver through either merged LMEs or through interlocal agreement among LMEs; use of managed care strategies to reduce escalating costs in Medicaid while ensuring medically necessary care and deploy a system for the allocation of resources based on reliable assessment of intensity of need; phase out the CAP-MR/DD waiver; and design the Innovations waiver to serve the maximum number of individuals with intellectual and developmental disabilities within aggregate funding. It also specifies that county governments will not be financially liable for overspending or cost overruns associated with the operation of the waiver (i.e., the risk doesn’t shift). HB 916 specifies a number of conforming statute changes regarding the size of LMEs. Section 4 also exempts the Department from rulemaking in implementing, operating, or overseeing new Medicaid waiver programs or amendments to existing Medicaid waiver programs. For DRNC’s updated position paper on the 1915 b/c waiver, please click here.

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