Some Notes from the November 19, 2013 HHS Oversight Meeting

The Joint Legislative Oversight Committee on Health and Human Services met this week to discuss a number of hot topics.  All of the handouts are online here. Make sure to check out the bullet point below on the subcommittees that will be meeting in the interim.  The next full Oversight meeting will be December 10.

Topics covered included:

• Medicaid Budget Update: There is alot of uncertainty around exactly where the Medicaid budget will come in, in large part due to a lack of claims data from the new NC Tracks system, as well as uncertainty as to whether directed budget cuts may be achieved. (Additional press coverage can be seen here).  Legislative staff also presented on administrative costs of NC's Medicaid program compared to other states, using a different analysis than previously used by the Department (beginning on slide 15 in this handout).
• Updates on the Status of Medicaid State Plan Amendments (SPAs), Personal Care Services (PCS) and changes to Medicaid Presumptive Eligibility under the ACA. Concerns raised by Sandy Terrell about the SPAs included whether those related to rate freezes will be approved, whether the directed savings can be achieved, and whether the shared savings plan can be implemented as directed in the legislation.
• NC Tracks Update: The Department claimed that they have resolved most, if not all, of the issues identified at the last meeting.
• Overview of Medicaid Reform Approaches Across the US by Bob Atlas, Consultant to DHHS. Mr. Atlas shared that their proposal will likely include a regional plan, rather than one state level contractor, with 5-7 regions and multiple contractors.
• US DOJ Agreement Implementation & Status of Housing Slots by Jessica Keith, Special Advisor on ADA, DHHS. Ms. Keith reported that the commitment from the LME/MCOs has been good, with most hitting their target housing placement goal. She also commented that the settlement implementation needs to be integrated into the mental health service system and not set up as a separate service system.
• Mental Health Crisis Solutions Initiative: Dave Richard presented on the Department's plans for this initiative. Solutions discussed included developing alternatives to Emergency Departments like walk-in crisis centers and short-term residential treatment options; expanded telepsychiatry; EMS Pilot Programs; Continued Crisis Intervention Team implementation; Mental Health First Aid and Person-Centered Crisis Prevention Plans and Wellness Planning.
• NC Health Information Exchange (NC HIE): CCNC began operating the HIE after the separate entity failed to get off the ground. HHS has not yet entered into a data sharing arrangement for the HIE.
• Subcommittee Appointments (These were announced during the committee but have not been posted online yet so please forgive any omissions or inaccuracies):
• Certified Nurse Midwives (S.L. 2013-360, Section 12I.2): Sens. Pate, Tarte, Woodard; Reps. Stevens, Avila, Wray.
• Impact of 1915(b)(c) Medicaid Waiver and Other Mental Health System Reforms on Guardianship (S.L. 2013-258, Section 3): Sens. Barringer, Randleman, Robinson; Reps. Jones, Dollar, Earle.
• Oversight of CSC Contract Performance & NC Tracks Implementation: Sens. Tarte, Tucker, Hise, D. Davis; Reps. Avila, Saine, Murry, Fulghum.
• Mental Health: Sens. Hartsell, Tucker, Pate, Parmon; Reps. Martin, Lambeth, Ford, Brisson.
• Note: Subcommittees Report to Oversight Committee on March 11, 2014