House Budget Update

The House budget will be considered in the House Appropriations committee tomorrow morning and voted on in the full House on Tuesday and Wednesday. This is a very quick rundown.

The House budget spends $12 mil less than the Senate budget. Points of particular interest: $8 million for individuals residing in group homes no longer receiving PCS;  adjustment to special provision language regarding prior authorization for psychotropic medications; change in eligibility for PreK; ADATCs no longer eliminated; and includes compensation for victims of the state’s sterilization program.

Health and Human Services

Division of Central Management and Support

·      Eliminates 6 positions in the Office of Citizen Services associated with CARE Line (also in Senate budget)

·      Funds for Nonprofits: Provides funds for historically funded non-profits for FY 2013-14. The Department is directed to create a competitive block grant process for the appropriation of these funds beginning in FY 2014-15. In addition to the state funds, Social Services Block Grant funds are appropriated for non-profits for FY 2013-14 in the amount of $3,194,751 for a total appropriation of $12,723,885. (Senate Modified)

·      $8 mil Group Home Funding: Appropriates funds for one year for group home residents who were determined to be ineligible for Medicaid personal care services on or after January 1, 2013. The maximum monthly payment is set at $464.30 and is based on providing 33 hours of service per eligible recipient. Group homes may only use these funds for: non-hands on assistance, supervision and medication management for a resident who meets the required eligibility criteria. Funds for this purpose are capped at a maximum amount of $8,000,000 and will end upon the implementation of a tiered State-County Special Assistance Block Grant program or upon depletion of the funds. (New House Item)

·      $2 mil for statewide telepsychiatry program

Division of Child Development and Early Education

·      5,000 additional PreK slots with $24.8 mil from lottery receipts (New House Item)

·      Changes PreK eligibility to lower income to 130% FPL and eliminates other risk factors such as development delays, health impairments and limited English proficiency.

Division of Social Services

·      $4.8 mil for child welfare services (identical)

·      $1.5 mil R for adoption promotion fund (new in House)

·      $1 mil for permanency innovation (House)

Vocational Rehabilitation

·      $10k reduction to administration for the Independent Living program

·      Reductions based on historical transfers to the Medicaid program and replacing general funds with program receipts

Aging

·      HCCBG - Reduces by $500k to replace expiring federal grant but does not take Project CARE statewide

·      LTC Ombudsman: $200k in '14-15 to replace lost federal receipts and maintain the current level of service.

Division of Public Health

·      Postpones closing Child Developmental ServiceAgencies by one year and directs the division to make it a priority to maintain the CDSAs that have the highest caseloads of children who reside in rural or medically underserved areas of the State.

·      ADAP - Gov's position, reduces funding for the AIDS drug assistance program

·      Did not adopt eliminations in oral health

Division of Mental Health

·      3 way beds - add beds with funds from reserve and implement tiered payment system

·      Wright school and ADATCs NOT closing

·      Funds from reserve for 19 additional beds at Broughton Hospital

·      $1.8 mil for the Child Treatment Program

·      Adult Developmental Vocational Program : $250k to the LME/MCOs to serve adults on the waiting list  for the Adult Developmental Vocational Program.

Division of Medical Assistance

·      $3.75 mil reduction to offset federal funds received through the Health Homes for Chronically Ill increased federal match

·      Increased Medicaid co-pays (Senate)

·      Modified shared savings payment plan - to 2%

·      Prior authorization for MH drugs out

·      Medicaid Reform Proposal - creates Medicaid reform advisory group

·       Pharmacy Changes - shift to payments based on invoice costs; Implement a limit of 4 brand prescription for each Medicaid recipient without prior authorization and work with CCNC to implement reporting to CCNC providers that identifies Medicaid patients by pharmacy provider needing compliance help, identifies patients upon discharge to appropriate pharmacy and recipients who are frequent users of Hospital EDs. (House budget)

·      Same Rehab and physician limitations as Senate budget

·      Additional funds for ACA woodwork effect and Medicaid Rebase

·      Additional PCS services- language taken out, policy will be in bill

·      Medicaid subrogation - policy will be in bill

·      IOM board reworking removed

Education

·      Opportunity Scholarships (Vouchers): $50 mil to creates grants of $4200/year for some low-income students to attend private schools. Expected savings of $12 mil in first year and $36 mil in second year from decreased public school enrollment. $10 mil in first year and $40 mil in second year allocated for the grants.

·      School safety: Provides $10 million in recurring support for School Resource Officers in elementary and middle schools, $2 million for installing and maintaining panic alarms in public schools, and $4 million for school psychologists, school counselors, and social workers.

·      Pilot program for sports programs for students with disabilities: No additional funding but he Department may use up to $300,000 to develop and implement a pilot program for an integrated community-based adapted sports program for students with disabilities in K-12. If the Department uses funds for this purpose, the pilot program shall be consistent with the "Dear Colleague" letter addressing equal access to extracurricular athletics for students with disabilities released by the U.S. Department of Education, Office for Civil Rights, on January 25, 2013. The pilot program shall also include specific strategies to overcome barriers to the participation of students with disabilities in extracurricular athletics and incorporate a philosophy of personal empowerment for those students.

Justice and Public Safety

Adult Corrections

·      Closes Duplin, Robeson, Wayne, North Piedmont Correctional for Women and Western Youth

·      $4.75 mil for substance abuse treatment services for offenders assessed as moderate to high- risk for recidivism and high need for substance abuse services.

Division of Juvenile Justice

·      Eliminates 3 full-time executive positions (Deputy Comm Courts and Programs, Deputy Comm Facilities and Director of Detention Services).

·      Lenoir, Richmond, Buncombe YDCs close.

·      Safer Schools Initiative: Provides funding for the Center for Safer Schools, which will provide training and technical support to educators, law enforcement agencies and parents statewide $311,572 Recurring, $5200 NR, 4 positions

Judicial

·      NCPLS funded, funding reduced by $231k due to declining prison population

·      Restores 16 Magistrate positions

General Government

Elections

·      Funds to implement Voter ID (also in Senate)

·      HAVA funds: Provides matching funds for federal HAVA funds to support the Statewide Election and Information Management System (SEIMS) and two time-limited positions in FY 2014-15. These additional funds will allow the State to access $4,071,740 of HAVA federal funds for information technology efforts.

Housing Finance Agency 

•   Reduction to Housing Trust Fund same as Senate

Reserves

·      Eugenics Compensation: Creates a $10 mil fund to provide $50,000 for each verified victim of the State's Eugenics Program, to continue the operations of the Justice for Sterilization Victims Foundation, and to provide funds for administration.