CORRECTED-House Health and Human Services Committee 11/29/11

This morning the House Committee on Health and Human Services met on short notice to reconsider H433, Local Human Services Administration. This bill previously passed the Committee in its fourth edition in June after much discussion. Another version, edition 3, was passed in the full Senate. The legislation would allow NC counties to consolidate several human services functions under a single authority, including: the current functions of health departments; departments of social services; and area mental health, developmental disabilities, and substance abuse services. Wake and Mecklenberg Counties already have this authority.

The Committee decided today to go back to the Senate-passed third edition in an effort to have the bill ratified today, since the Senate recessed last night and will not consider any more bills during this mini-session. Democrats in the Committee raised concerns over the process by which the change was made, the precedent of allowing the Senate to dictate the substance of bills passed by the House, and about the removal of certain provisions agreed to in the fourth edition of the bill. Notably, the fourth edition included: a provision allowing county commissioners to subject employees of the consolidated agencies to the State Personnel Act, an exemption for any hospital authority assigned to provide public health services, an incentive program providing monetary incentives for public health improvement, and changes to the list of “essential public health services” under 130A-1.1(b).

The bill failed on a procedural vote on the House floor. Expect this bill to come back in February.

Joint Legislative Oversight Committee on the Department of Health and Human Services

The HHS Oversight Committee met November 8 to get updates from the Department of Health and Human Services on a number of issues important to people with disabilities in NC. A great deal of the time was spent on efforts to meet the budget requirements imposed by the legislature this summer. Secretary Cansler reported the current shortfall for Medicaid is $139 million. As he has said before, Cansler indicated that the only way to fill that gap without additional money is to cut provider rates by 18% for the last three or four months of the fiscal year or to eliminate all Medicaid optional services (except pharmacy) during the same time period. No cuts to services could be implemented immediately because such changes require approval of federal authorities. Perhaps the brightest spot in the session was that Chairman Nelson Dollar indicated the legislature found both of those possibilities untenable and would find a way to avoid them. No word on where the money would come from. DHHS’s responses to questions posed by committee members is available at the committee website here.
Dr. Beth Melcher gave the Department’s update on the implementation of the 1915 b/c Medicaid waiver. She indicated the process is moving forward, with the identification of the entities that will eventually become the Managed Care Organizations running the waiver programs completed in October. Eleven such organizations have been identified. Those organizations will either subsume or partner with other LMEs to provide services statewide.