Budget Summary

Summary of 2012 Budget

The NC House and Senate came to an agreement this week on the 2012 budget. The total budget spends 2.5% more than the budget as approved last year.  Unfortunately, the budget does not include compensation for victims of North Carolina’s sterilization program.  The Governor now has 10 days to veto the budget.  The budget was approved by a veto-proof majority in both chambers so any veto would likely be overridden.  The legislature plans to adjourn as soon as possible after a veto override, which would be Monday, July 2d at the latest.

Below is a brief summary of the budget items related to the work of Disability Rights NC.  The full budget is online here.  The money report is online here.

Education Budget

·      LEA Adjustment Reduction - $143 mil to reduce cuts to LEAs, still leaves huge shortfall from expiring federal funds used to curb previous cuts

·      Residential Schools - None will be closed.  Restores $4.7 mil of cuts. Section 7.3 discusses School Improvement Plans, Section 7.8 repeals consolidation.

·      Section 7A Excellent Public Schools Act: $27 mil: developmental screening and Kindergarten entry assesement; elimination of social promotion; reading development for retained students; school performance grades; establishes NC Teacher Corps; allows for local plans for performance pay.

Health and Human Services Budget

Division of Medical Assistance

• $59 mil in CCNC savings
• Reduced savings expected from 1915 b/c waiver transition by $1.7 mil, due to delays
• $3.8 mil savings from fraud, waste and abuse prevention
• Restructure Fee for Service for $2 mil savings
• $14 mil CHIPRA bonus
• $15 mil for cost settlements with providers and fraud, waste and abuse initiatives
• $6 mil reduction associated with changes to PCS program
• Section 6.12 – Requires Medicaid disclosures to fiscal research (Senate budget item)
• Management flexibility reductions across departments to achieve savings for Medicaid program (Section 6.14): In order to provide adequate funds to cover any potential shortfall in the 2012-2013 Medicaid budget while minimizing the impact on State government services, the Director of the Budget shall ensure that cost savings required through the management flexibility reductions in this act are realized so that at least fifty percent (50%) of the cost savings are realized by December 31, 2012.
• Limits on ST/OT/PT repealed.
• COLA disregard (Section 10.6):  Income disregard for Medicaid effective January 1, 2013.  Sunset of December 31, 2017.
• Medicaid Non-Emergency Medical Transportation - develop an RFP for management.  House had $1 mil in associated savings, that amount is not in final budget.
• Pharmacy services (Section 10.8): keeps $24 mil in projected savings from increased use of generics.  Adds expanded prior authorization to save $5.3 mil; special pharmacy program for hemophilia drugs.
• Section 10.8A - Study electronic prior authorizations for prescriptions
• Section 10.9 Smart Card Pilot Program - $1 mil to implement
• Section 10.9A State Auditor Audit of DMA: The audit shall examine the program's effectiveness; results of the program; the utilization of outside vendor contracts, including the number, cost, and duration of such contracts; fiscal controls and Medicaid forecasting; and compliance with requirements of the Centers for Medicare and Medicaid Services and the requirements of State law.
• Section 10.9B PED/FRD Study of Medicaid Organization: The Program Evaluation Division and the Fiscal Research Division of the General Assembly shall jointly study the feasibility of creating a separate Department of Medicaid and make a joint recommendation on this issue to the 2013 Regular Session of the General Assembly no later than February 15, 2013.
• Section 10.9C: No authority to reduce provider rates or services:  DHHS shall not reduce Medicaid provider payment rates or Medicaid optional services except as otherwise provided to achieve Medicaid pharmacy program savings.
• 10.9E Special Care and Memory Care Units: DMA shall develop and submit to CMS an application for a home- and community-based services program under 1915(i) for elderly individuals who (i) are typically served in special care  and memory care units that meet the criteria of the State-County Special Assistance Program  and (ii) have been diagnosed with a progressive, degenerative, irreversible disease that attacks  the brain and results in impaired memory, thinking, and behavior. The home- and  community-based services program developed by the Department pursuant to this section shall  focus on providing these elderly individuals with personal care services necessary to ameliorate  the effects of gradual memory loss, impaired judgment, disorientation, personality change,  difficulty in learning, and loss of language skills.
• PCS 10.9 F added limited assistance with 3 ADLs: Directs implementation of PCS  for recipients who have a medical condition, disability, or cognitive impairment and demonstrates unmet needs for, at a minimum, (i) three of the five qualifying activities of daily living (ADLs) with limited hands-on assistance; (ii) two ADLs, one of which requires extensive assistance; or (iii) two ADLs, one of which requires assistance at the full dependence level.   The five qualifying ADLs are eating, dressing, bathing, toileting, and mobility.  The recipient resides either in a private living arrangement, a residential facility licensed by the State of North Carolina as an adult care home, or a combination home as defined in G.S. 131E-101(1a).
• Appropriations Contingent upon adequacy of funding for Medicaid budget (Section 10.9G): DHHS shall not expend funds appropriated for the following purposes until January 1, 2013, pending a determination by the Office of State Budget and Management that there is adequate funding for the Medicaid budget for the 2012-2013 fiscal year: (1) Funds appropriated to DCDEE for NCPC; (2) DMH/DD/SAS funds for additional psychiatric care beds at Broughton Hospital and additional local inpatient psychiatric beds or bed days available to LMEs and MCOs under the State-administered three-way contracts ($9 mil additional); and (3) funds appropriated to DPH for local community health and wellness initiatives.
• Examination of the state's delivery of MH Services (Section 10.11): Directs the HHS Oversight committee to appoint a subcommittee to examine the State's delivery of mental health  services. As part of its examination, the subcommittee shall review all of the following:  (1)  The process for determining the catchment areas served by the State's psychiatric hospitals, with consideration of both of the following:   (a) Factors used in assigning the geographic groupings of local management areas and managed care organizations into catchment areas. (b) Alternatives to the current process for determining the catchment areas served by the State's psychiatric hospitals, including a determination of whether there is a more efficient and equitable manner of assigning hospital catchment areas. The subcommittee shall report its findings and recommendations to the Joint Legislative Oversight Committee on Health and Human Services  on or before January 15, 2013, at which time it shall terminate.
• AIDS Drug Assistance Program Pilot (Section 10.16)
• $5 mil reduction to nonprofits (Section 10.18), minimizing 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.
• SA In-home (Section 10.23) - keeps 15% cap (although can be waived by the Secretary) but equalizes the amount, all counties shall participate, a formula will be established

DCDEE

·      PreK - $15 mil increase in House - NO increase in final budget.  Directs DCDEE to continue implementation of the NC Pre-K program.  Includes chronic health and developmental disabilities as factors for eligibility requirements along with 75% of the state median income

• $3.5 mil to NCPC for early literacy and TA re grant and fundraising - after January 1 only if not needed for Medicaid

Div of Central Management

·      $2.7 mil reduction for administrative efficiencies

·      Non-state entity pass-through funds - makes NR and 10% match to entities like Arc, Autism Society, Easter Seals

Div of Aging and Adult Services

·      Transition to Community Living $10.3 mil (10.23A) - Blue Ribbon commission, DOJ same

·      Short Term Assistance $39.7 mil monthly rate for residents while they "transition," Sets out amount per resident that may be paid, steps it down after 3 months, expires June 30, 2013.

DMH

• No restoration of MH community service funds - $20 mil cut
• 3 way contracts - $9 mil increase Jan 1, 2013 contingent upon Medicaid, was increase of $18.5 mil in House budget
• LME Admin Funds reduced by $8.5 mil
• Cherry Hospital - funding for increased bed capacity (124 beds) at the new Cherry hospital $3.5 mil
• Broughton Hospital - 19 addnl psych beds $3.5 mil after Jan 1, 2013 if money not needed for Medicaid
• Drug Treatment Courts - $2.3 mil eliminated

Div of Public Health

·      Medication Assistance Program - $1.7 mil NR in House budget

·      $4.9 mil to county health departments for community health and wellness initiatives, contingent upon Medicaid

Justice and Public Safety

·      DPS Management Flexibility Reductions – $26.3 mil – In implementing, the department shall NOT close the Bladen Correctional Center, reduce community program funding in either the Div of Adult Correction or Juvenile Justice, or eliminate any district level state highway trooper position

Corrections

·      Revised the Inmate Medical Costs special provision

Juvenile Justice

·      Close Edgecombe YDC Jan 1, 2013.  Transfer 10 youth counselor associate positions, 5 to Chatham and 5 to Lenoir to increase their bed capacity.  Also directs a study  of the use of the facility.

·      Multipurpose Group Home Funds (Section 14.6) - $550,000 for a multipurpose group home in Craven county

Justice

·      $1.8 mil reduction to eliminate state funding to Consumer Protection division

·      IDS - no changes

·      AGs must begin doing itemized bills for their work for agencies, must also do biannual reports

General Assembly

·      Program Evaluation Division shall study the duties and services of the NC Human Relations Commission and the Civil Rights Division of OAH to determine whether there is unnecessary overlap and duplication of services and recommend the placement of the Commission and Division in the appropriate agency or agencies.

State Board of Elections

·      HAVA Funds/Disability Access:  Directs the State Board of Elections to retain HAVA Title II funds until MOE funds are appropriated, EXCEPT for voting accessibility funds under Section 261 of HAVA.

Salaries and Benefits

·      State employee and public school employee 1.2% salary increases

Office of the Governor – Housing Finance Agency

·      Housing Trust Fund - eliminates General Fund appropriation and appropriates $7.9 mil from Mortgage Settlement Agreement

Bill Update for the Week of June 11

The big news at the legislature this week was the Senate version of the state budget.  The Senate took a very "minimalist" approach to the budget - eliminating dozens of state funded programs for children, people with disabilities, and the aging population. This version of the budget was approved by the Senate along party lines on Thursday.  The House voted not to concur with the Senate budget on the same day, and a conference committee was appointed. The conference committee will meet in private over the weekend in the hopes of working out a compromise budget.  Some Senate members project that they will adjourn as early as next week.

In the meantime, bills on non-budget related matters are working through the process.

Bill Update

HB 614, Enact Volunteer Health Care Services Act (Jordan, Glazier, Lucas). HB 614 provides for regulation of volunteer health care providers under certain circumstances. This is a House bill that was originally filed for another purpose but was changed in the Senate. It is scheduled for a concurrence vote in the House next week. 

HB 1048, Incapacity to Proceed Amendmets (Randleman, Hurley, Faircloth, McGuirt sponsors). HB 1048 seeks to make various changes to NC law applying to individuals who do not have the capacity to proceed in criminal matters. DRNC participated in the study committee from which these recommendations came and we support the bill.  It was approved by the  House Judiciary A committee and the full House this week.  It has been referred to the Senate Judiciary II committee.  We are hopeful that the Senate will allow a meeting of this committee so that the bill may proceed to become law.

HB 1075, LME/MCO Governance (Dollar, Burr sponsors).  HB 1075 suggests several changes to the laws governing the local management entities, including board structure, the ability of a county to disengage from an LME, the ability to own property and borrow money, and to keep confidential "competitive health care information."  It also proposes provisions that seek to provide continuity in guardianship for individuals who have been wards of LMEs.  The current version of the bill creates a new Part 2B governing Behavioral Health Authorities, an entirely new entity under the law.  The bill was removed from the Senate calendar last week and re-calendared for the upcoming week.

HR 1191, Resolution of Disapproval of Reorganization (Cleveland).  HR 1191 seeks to disapprove the portion of Executive Order 85, issued last year by the Governor, that ordered the merger and reorganization of several government departments and divisions, including the merger of Vocational Rehabilitation, Services for the Blind and Deaf and Hard of Hearing.  The bill has been approved by a House committee and is eligible for a floor vote but was withdrawn from the calendar and put in the House Rules committee. 

SB 707, School Violence Prevention Act (Tucker). As originally filed, SB 707 had a number of provisions that DRNC objected to.  However, the bill has been significantly modified since it was originally filed and we have dropped our opposition.  The bill now makes clear that school personnel who take reasonable actions in good faith to end a fight or altercation between students will not incur any civil or criminal liability as the result of those actions; adds a new section to the state law regarding cyber-bullying of a school employee by a student; adds a section regarding probation officer visits at school; and prohibits intimidation of a school employee regarding reporting of an assault.  It was approved by the House Judiciary B committee this week and is now scheduled to be heard by the full House on Monday. 

 SB 724, An Act to Improve Public Education (Stein, Tillman).  SB 724 provides additional standards for teacher training; directs the State Board of Education to reconsider the high school graduation requirements for students who do not plan to continue education beyond high school; directs the creation of transition teams and transition plans for students at risk to assist them in making a successful transition between the elementary school and middle school years and between the middle school and high school years; and it removes a sunset of 2013 on a state law regarding a school's basis of knowledge of a child with a disability.  Because changes to the bill were made in the House, the bill must now go back to the Senate for a concurrence vote, which is scheduled for Monday.

 SB 756, Amend Bail Law/Pretrial Release Programs (Clary, East, Jones). The bill seeks to restrict the use of pretrial release programs, and in turn, increase the number of defendants who are released on bond.  It was approved by the Judiciary C committee this week despite a great deal of opposition.  It will next be voted upon by the full House.

Legislative Update for the Week of June 4

It was another very busy week at the North Carolina legislature.  A bill setting the date for adjournment as June 19 was filed in the Senate.  In line with that date, the Senate set Friday, June 8 as the last day for policy committee meetings in order to focus on the budget.  Comments from the House leadership that they are also hoping for an adjournment during the week of June 18 are in line with the Senate date.  The Senate will vote on its budget in the full Appropriations committee on Tuesday.  Stay tuned for a budget update this week.


Bill Update


HB 947, Eugenics Compensation Program (Womble, Tillis, Parmon and Stam sponsors). This legislation seeks to provide $50,000 to verified individuals who were forcibly sterilized by the state of North Carolina. Disability Rights NC has provided input and is following this legislation to ensure that recipients who currently receive public assistance are protected to the maximum extent possible.  The bill was approved by the full House this week 86-31 with an amendment to move the cutoff date for recipients from March 2010 to the day bill the bill was introduced, May 16, 2012.  This will leave out 2 identified individuals who have died since March 2010.  The future of the bill in the Senate is uncertain.  It has been referred to the Senate Judiciary II committee, which will likely not be meeting again. The Senate may include a modified version in the budget.


HB 966, Teacher Prepayment, Clarify Eligibility for the NC PreK Program (Holloway, Johnson, Blackwell, Hilton sponsors).  The House approved HB 966 this week hours before oral arguments on the Leandro case.  The bill states that the Division of Child Development and Early Education shall create income eligibility requirements that do not exceed 75% of state median income, which is the current eligibility limit. This is a positive step in light of the efforts last spring to reduce income eligibility to the Federal Poverty Line. Additionally, the bill clarifies that at least 80% of the children served by the program must meet income requirements, while the other 20% can be eligible for other reasons. This provision clarifies unclear language in last year’s budget that seemed to state that at-risk children should only constitute 20% of the program’s participants.  

HB 981, Dix Property Sale to Require GA Approval (Dollar, Burr and Hurley sponsors). HB 981 prohibits the sale of the Dorothea Dix property without the approval of the General Assembly, specifies that the net proceeds of any disposition shall be used to facilitate reform of the MH/DD/SA system and provide start-up and operating support for programs and services that provide more appropriate and cost-effective community treatment alternatives for individuals currently residing in state institutions.  It also states that funds made available from the net proceeds of such a disposition shall be provided in addition to, and not supplant, appropriations for MH/DD/SAS institutions.  The bill received unanimous approval in the House this week.  The bill has been referred to the Senate Finance committee.

HB 1075, LME/MCO Governance (Dollar, Burr sponsors).  HB 1075 suggests several changes to the laws governing the local management entities, including board structure, the ability of a county to disengage from an LME, the ability to own property and borrow money, and to keep confidential "competitive health care information."  It also proposes provisions that seek to provide continuity in guardianship for individuals who have been wards of LMEs.  It was approved by the full House this week and also cleared the Senate Mental Health committee.  The Proposed Committee Substitute approved in the Senate committee added a new section to the bill that creates a new Part 2B governing Behavioral Health Authorities, an entirely new entity under the law.  As of now, only PBH would qualify as a behavioral health authority (must have been an MCO for at least three years) - the bill provides for a different board structure and, different duties of directors and of the entity.  The PCS also allowed an exemption for Medicaid appeals from the current state law process.  DRNC strongly objected to this provision and an amendment removing the provision was approved.  The bill will next be considered by the full Senate.  If approved, the bill will need to go back to the House for consideration of the changes.  Because the added section is such a major change, it is probable that the House will not concur in the committee substitute, and differences will be worked out in conference.

HR 1191, Resolution of Disapproval of Reorganization(Cleveland).  HB 1191 seeks to disapprove the portion of Executive Order 85, issued last year by the Governor, that ordered the merger and reorganization of several government departments and divisions, including the merger of Vocational Rehabilitation, Services for the Blind and Deaf and Hard of Hearing.  The bill was approved by the Judiciary C committee this week but has not yet been calendared for a vote of the full House.  To disapprove an Executive Order, only one chamber need act.

SB 434, Raise the Age (Avila and Lewis).  After long wait, the Raise the Age bill (SB434) was heard in the House Judiciary A Committee this week.  This version of the bill is a phased-in approach beginning in 2016; applies to misdemeanor offenses only; and only applies if accused has no prior felony convictions.  Judge Marcia Morey, Chief Frank Palumbo and Action for Children’s Brandy Bynum all testified in favor of the bill. The bill’s primary sponsors, Rep. David Lewis and Rep. Marilyn Avila, made a strong and articulate case for the bill as well. Unfortunately, Committee Chairman John Blust decided not to take a vote on the bill and said that he would need to be instructed by House leadership to initiate further action.  At this point, it’s unclear if that will happen.

 SB 795, Excellent Public Schools Act (Berger, Apodaca and Tillman).  SB 795 is Senator Berger's much-touted eduction reform legislation.  If passed, the legislation would make changes to improve K‑3 literacy; provide literacy volunteer leave time to state employees; assign school performance grades;  adjust school calendar; fund five additional instructional days within the existing school calendar; establish an NC Teacher Corps; modify teacher Licensure Requirements;  establish merit pay for teachers; address NC Pre‑K Program Eligibility and add some funding back; and eliminate campaign financing for the Superintendent of Public Instruction.   The bill was approved by the full Senate this week.  There are rumors that the bill may be included in the final budget. It has been referred to the House Education committee.

SB 810, Regulatory Reform Act of 2012 (Rouzer, Brown, Davis sponsors).  SB 810 makes various changes to the Administrative Procedures Act.  Of relevance to the work of DRNC, is the provision that extends the date by which final decision-making authority passes from the Division of Medical Assistance to the Office of Administrative Hearings to February 1, 2013, or when the waiver is granted, whichever comes first.  SB 810 received final approval from the full Senate this week after several amendments on the Senate floor were approved.  One amendment adds a provision to the power of the Administartive Law Judge to award attorneys fees in a contested case to state that the judge may award attorneys fees when it is found that the state agency has substantially prejudiced the petiotioner's rights and has acted arbitrarily or capriciously.  The bill passed the full Senate this week and will now proceed to the House.  It has been referred to the House Commerce committee.

SB 851, Boards and Commissions Efficiency Act of 2012 (Brown, Rouzer, Soucek sponsors).  SB 851 seeks to downsize or eliminate dozens of boards and commissions.  The bill was heard in the Senate Program Evaluation committee, where it was extensively modified.  We are happy to report that the following committees that were proposed for elimination were removed from the bill altogether: Governor's Council on Aging, Consumer and Advocacy Advisory Committee for the Blind, and the Interagency Coordinating Council of Children from Birth to Five with Disabilities and their Families.  The NC Brain Injury Advisory Council, which had been proposed for elimination, will continue operating until 2019.  The proposed downsizing of the North Carolina Council on Developmental Disabilities was removed.  The Commission for MH/DD/SAS will still be downsized but to a lesser extent.  Finally, the Governor's Crime Commission was renamed the North Carolina Crime Commission, and downsized from 38 to 24 voting members.  It has been referred to the Senate Finance committee.

Bill Update for the Week of May 28

Despite the holiday on Monday, the legislature still managed to pack in a very busy week. The House approved its version of the budget. Committees discussed major legislation and also voted on some pretty major policy issues. There are three sections below - Bill Updates (legislation which was acted upon this past week); New Legislation of Interest Filed this week; and a summary of the House budget passed this week.

Bill Updates

 HB 423, Adult Care Home Pilot/Buncombe County (Hurley).  HB 423 was originally filed as a bill regarding involuntary commitment.  A Proposed Committee Substitute reflecting the new title was presented in the Senate Mental Health committee this week.  The bill now directs a pilot program in Buncombe County for a more detailed assessment tool for adult care home residents and to allow the county DSS to delegate its Adult Care Home monitoring duties.  The legislation was drafted at the request of legislators from Buncombe county who have heard many complaints about a particular facility.  The Department of Health and Human Services expressed concerns at the committee meeting that the pilot program may be in direct contradiction to positions taken with regard to the DOJ investiogation involving adults with mental illness in Adult Care Homes.  DRNC has an additional concern about contracting out the monitoring duties.  The legislation was not voted upon and is scheduled to be taken up again next week.

HB 493, Landlord Tenant Law Changes (Howard, Blust, Randleman Sponsors). HB 493  modifies the section of the Landlord Tenant laws regarding rent pending execution of judgment; raises the value of personal property that may be donated or disposed of after a tenant abandons or has been ejected, and sets out a procedure for removing personal property after a tenant has died; modifies the permitted uses of the deposit; and makes small changes to the laws on vacation rentals regarding cleaning fees. A PCS was approved in the Senate Judiciary committee this week and the bill is set for final approval in the full Senate next week.

HB 947, Eugenics Compensation Program (Womble, Tillis, Parmon and Stam sponsors). This legislation seeks to provide $50,000 to verified individuals who were forcibly sterilized by the state of North Carolina. Disability Rights NC has provided input and is following this legislation to ensure that recipients who currently receive public assistance are protected to the maximum extent possible.  It was approved by the House Appropriations committee, and will now be heard by the full House before proceeding to the Senate.

HB 981, Dix Property Sale to Require GA Approval (Dollar, Burr and Hurley sponsors)/SB 833 (Pate). HB 981 prohibits the sale of the Dorothea Dix property without the approval of the General Assembly. It was heard and approved by the House Health and HUman Services committee this week.  A Section 2 was added to the bill to specify that the net proceeds of any disp[osition shallo be used to facilitate reform of the MH/DD/SA system and provide start-up and operating support for programs and services that provide more appropriate and cost-effective community treatment alternatives for individuals currently residing in state institutions.  Representative offered an amendment that states that Funds made available from the net proceeds of such a disposition shall be provided in addition to, and not supplant, appropriations for MH/DD/SAS institutions.  The bill will next be heard by the full House before proceeding to the Senate.

HB 1075, LME/MCO Governance (Dollar, Burr sponsors)/SB 875 (Pate).  HB 1075 and SB 875 suggest several changes to the laws governing the local management entities, including board structure, the ability of a county to disengage from an LME, the ability to own property and borrow money, and to keep confidential "competitive health care information."  It also proposes provisions that seek to provide continuity in guardianship for individuals who have been wards of LMEs.  Both bills were heard in committee this week, although neither was voted upon.  Both are scheduled to be heard in their respective committees next week.

 SB 795, Excellent Public Schools Act (Berger, Apodaca and Tillman).  SB 795 is SEnator Berger's much-touted eduction reform legislation.  If passed, the legislation would make changes to improve K‑3 literacy; provide literacy volunteer leave time to state employees; assign school performance grades;  adjust school calendar; fund five additional instructional days within the existing school calendar; establish an NC Teacher Corps; modify teacher Licensure Requirements;  establish merit pay for teachers; address NC Pre‑K Program Eligibility and add some funding back; and eliminate campaign financing for the Superintendent of Public Instruction.   It was approved by Senate Appropriations and Finance, and approved on 2d reading in the full Senate on Thursday.  It is scheduled for final approval in the Senate on Monday night, before proceeding to the House, where the future of the bill is quite uncertain.  

SB 810, Regulatory Reform Act of 2012 (Rouzer, Brown, Davis sponsors).  SB 810 makes various changes to the Administrative Procedures Act.  Of relevance to the work of DRNC, is the provision that extends the date by which final decision-making authority passes from the Division of Medical Assistance to the Office of Administrative Hearings to February 1, 2013, or when the waiver is granted, whichever comes first.  SB 810 received final approval from the full Senate this week after several amendments on the Senate floor were approved.  One amendment adds a provision to the power of the Administartive Law Judge to award attorneys fees in a contested case to state that the judge may award attorneys fees when it is found that the state agency has substantially prejudiced the petiotioner's rights and has acted arbitrarily or capriciously.  The bill will now proceed to the House.

 New Legislation of Interest Filed This Week


HB 1153, Standard for Charter Schools/Durham County (Luebke, Michaux, Hall).  HB 1153 seeks ti require all charter schools in Durham County to provide transportation to students, free or reduced price lunch to eligible children, and have policies for students with disabilities  that comply with federal laws including IDEA.  IT also specifies that charter schools shall not limit admission to students on the basis of intellectual ability, measures of achievement, or  measures of aptitude. It has been referred to the House Education committee.


HR 1191, Resolution of Disapproval of Reorganization (Cleveland).  HB 1191 seeks to disapprove the portion of Executive Order 85, issued last year by the Governor, that ordered the merger and reorganization of several government departments and divisions, including the merger of Vocational Rehabilitation, Services for the Blind and Deaf and Hard of Hearing.  It has been referred to the House Judiciary C committee.


HB 1196, Albemarle Health Center Property (Owens). The bill seeks to allow the Director of the Division  of MH/DD/SAS to wind up the affairs of the Albemarle Mental Health Center by entering into any necessary interlocal agreements and conveying its interests in real property in Camden, Currituck, and Perquimans Counties to East Carolina Behavioral Health (ECBH) as provided in the consolidation agreement between AMHC, ECBH, and the 10 counties in the catchment area.  It has been referred to the House Government committee.


SB 928, Repeal/Streamline DPI Reporting Requirements (Tucker).  SB 928 seeks to remove a number of public school reporting requirements, including reports on school discipline and school violence.  It has not yet been referred to a committee.

Budget Update


The House passed its version of the budget this week.  The biggest news on disability rights issues is the inclusion of $10.3 million to support DHHS in its plan for transitioning individuals with severe mental illness and severe and persistent mental illness into community living arrangements, including establishing a rental assistance program.  If the State executes an agreement with the U.S. Department of Justice (USDOJ) in response to USDOJ findings dated July 28, 2011, these funds may be used to implement the requirements of the agreement.  In the DRNC press release, Executive Director Vicki Smith stated “While ten million dollars is certainly not enough to solve the crisis of institutionalization identified by the Department of Justice, it is a step in the right direction.”


However, the bill allocates another $39.7 million to assist Adult Care Homes to transition into a "key component of the State’s Transitions to Community Living Initiative." DRNC urged lawmakers to devote more funds directly to assisting individuals with mental illness as they move to more integrated settings. “Sending tens of millions in taxpayer dollars to institutions is no way to solve our state’s institutionalization problem,” said Smith.

The House budget also proposes a short-term commission to study and recommend improvements to the State’s system of care for adults with mental illness and developmental disabilities. “While we applaud the attention given to these underserved populations, we are disappointed that the commission membership includes representatives from the adult care home industry, which does not provide mental health services. Any providers included in the commission should be those experienced with the delivery of community-based services, including mental health care. The inclusion of the ACH industry in the required membership is inappropriate and will only slow efforts at de-institutionalization,” said Smith. 

Below is a department-by-Department summary of the House budget:

Health and Human Services

Div of Medical Assistance (Medicaid)

• NO changes to optional services or provider rates.
• Medicaid Rebase $168 mil for increased enrollment and consumption
• $55 mil in Medicaid non-recurring liabilities
• CCNC Savings $60 mil reduction - total of $200 mil reduction over the two years.
• 1915 b/c waiver - increases savings to be achieved through expansion by $630K
• Fraud, waste and abuse detection and prevention - $3.8 mil savings
•  Restructure fee for service - $2 mil savings
• Pharmacy improvements savings of $6.7 mil pricing for hemophilia drugs, prior authorization, lower dispensing fees)
• CCNC Home health initiatives - CCNC will manage - $4.5 mil in savings, in Medicaid and CCNC budgets
•  $1 mil savings for non-emergency medical transportation, going to do an RFP for management of
• Medicaid Therapies Limit - repeals the provision in last year's budget to eliminate or limit adult physical therapy, occupational therapy, and speech therapy visits to three visits per calendar year.
• COLA disregard - enacts an income disregard for federal cost of living adjustments (COLA).  DRNC has long supported this action and is thrilled at its inclusion.  DHHS stated that 9200 people lost benefits this year because of COLAs. 
• Modify and improve Pharmacy Services - must achieve savings of $30 million.
• Smart Card Pilot program - prevents the department from rolling out statewide
• Inpatient Psych Beds or bed days - 91 additional beds
• Examination of the state's delivery of mental health services - to examine how mental health services are delivered and look at geographic areas for state

Div Central Management

• Admin efficiencies $1 mil reduction
• $1.5 mil reduction for vacant positions - directed to minimize the elimination of positions  
• Non state entity pass-through funds - makes recurring funds to nonprofits including Arc, Easter Seals and Autism Society non-recurring and adding a 10% match requirement

Aging

• Increase HCBG block grant funding $1.5 mil, services for 1100 persons

DMH/DD/SAS

• $10 mil NR reduction continues to LME community services funding (was $20 mil)
• $18.1 mil for three way contracts; did not include language to fund existing beds
• $8.5 mil reduction for LME admin
• $3.5 mil for Cherry - ongoing operating costs for new Cherry hospital, 125 more beds
• $3.5 mil for Broughton - open 19 beds at Broughton (58 positions, Recurring)
• $2.3 reduction to Drug Treatment Courts since JPS eliminated last year
• Eliminates $200K to MHA that was still in the budget

Div of Public Health 

• $5.5 mil for tobacco cessation
• County health department funds for community health and wellness initiatives that promote healthy behaviors (incl smoking cessation) - $8.5 mil 
• $375K for ECU High Risk Maternity Clinic

Division of Child Development and Early Education

• Replace $4 mil in Smart Start funds with federal block grant funds
• $15 mil increase for NC PreK, will fund an additional 1,765 students (restores less than half of last year's cuts)
• NC Partnership for Children  $3.5 mil restoration for literacy pilot, development consultants and rural partnership assistance

Justice and Public Safety

• Shift inmate medical costs to Medicaid $2 mil.  Will pay state portion.
• Close Edgecombe YDC $1.7 mil reduction - there many unsuccessful attempts to amend this provision
• Consumer Protection section of AG’s office to become 100% receipt supported.  $1.7 mil reduction.
• No changes to IDS
• Restores $2.9 mil R appropriation to family court
• Repeal requirement regarding the staffing treatment model at the YDCs
• $550K shall be used for multipurpose group home in Craven County
• Itemized billing for legal services provided by AG’s office to state agencies
• Biannual reporting on DOJ attorney activity

Education Appropriations

• Provides funding to restore 66.3% of the LEA Adjustment.
• $900K for Teach for America
• $5.15 mil to keep all three residential schools open
• Eliminates state subsidy to UNC hospitals - $44 mil recurring
• School Improvement Plans at Residential Schools reinstated
• Residential Schools: DPI can’t transfer any school-based personnel from the residential schools to central office administrative positions; and proceeds from rental of campus buildings shall be used for operation of schools and not DPI administrative functions

General Goverment

• Reduced general fund appropriations to Housing Trust Fund by $4.3 mil, to be offset by mortgage settlement
• Clarifies that HAVA Funds to improve voting accessibility for the disabled may be expended
• PED to study Human Relations Commission and Civil Rights Div of OAH