Bill Update for the Week of May 21

The North Carolina legislature came back to Raleigh for the 2012 short session last week, on May 16. This session is indeed expected to be short, with both House and Senate leadership proclaiming that the session will adjourn by the beginning of July. Starting this week, we will resume the weekly bill updates.

New Legislation Filed


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 received a favorable report from the House Judiciary and Finance committees this week. It is next scheduled to be heard in House Appropriations.

HB 948, Repeal Literacy Test (Alexander, K.). HB 948 proposes a constitutional amendment to repeal the requirement that persons present themselves for voter registration and read and write a section of the Constitution, both of which requirements have been prohibited by federal law. It was filed in the House last week and referred to the House Judiciary committee.

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 has been referred to the House Health and Human Services committee.

HB 1002, Bill of Rights/Deaf/Hearing Impaired (Blackwell, Holloway, Jordan and Gill sponsors). HB 1002 seeks to add particular communication needs needs of a child who is deaf or hard of hearing that must be addressed in the IEP process. It was referred to the House Judiciary A committee.

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 has been referred to the House Judiciary A committee.

HB 1055, Eliminate LME Provider Endorsement (Burr, Dollar sponsors)/SB 835 (Pate).  HB 1055 seeks to remove the LME provider endorsement provisions from the state statute.  This bill was a recommendation of the Joint Health and Human Services Legislative Oversight Committee.  It has been referred to the House Health and Human Services committee.

HB 1075, LME/MCO Governance (Dollar, Burr sponsors)/SB 875 (Pate).  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 has been filed in the House but not yet referred to a committee.

HB 1146, Make Disabled Child Ed. Tax Credit Refundable (Stam, Randleman, Jones, Jordan sponsors).     This  tax credit that was passed by legislation in 2011 (for families of students with disabilities who send their child with a disability to a private school).  This bill would make that credit refundable, i.e., if the credit led to an overpayment of taxes, that portion would be refundable to the family.  It has been filed in the House but not yet referred to committee.

SB 797, Payment of 2012 Medicaid Costs/Inmate Medical Costs (Brunstetter, Hunt, Stevens sponsors).  SB 797 was filed on the first day of session to allow the Governor to move money from various sources to cover the Medicaid shortfall.  The bill was amended in the House to prohibit any request for proposals for, or enter into any new contract for, the operational  oversight or management of health care services for inmates in the State prison system (i.e., privatize) without the prior approval of the General Assembly through a legislative act. However, it does make clear that the Department of Public Safety may continue to enter into contracts with providers to staff clinics within the existing health care delivery system without prior approval.  The prison provision was added after concerns were raised by the State Employees Association of NC.  The bill has passed both chambers and has been presented to the Governor.

SB 798, Various Emergency Management Changes (Brunstetter).  SB 798 makes various changes to the statutes and establishes the Joint Legislative Emergency Management Oversight Committee.  The bill has already been approved by the Senate and referred to the House.

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.  The bill received a favorable report from the Senate Commerce committee and will next be heard by the full Senate.

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, including the NC Council on Developmental Disabilities (downsize), Brain Injury Advisory Council (eliminate), Interagency Coordinating Council of Children from Birth to Five with Disabilities and their Families  (eliminate), and Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services (downsize).  The bill has been referred to the Senate committee on Program Evaluation.

Report- NC Children with Complex Disabilities

Disability Rights North Carolina has released a new report on our state's failure to adequately serve children with complex mental health care needs. Check it out on our website: http://www.disabilityrightsnc.org/.

Eugenics Compensation Task Force Finalizes Recommendations

This morning the Governor's Eugenics Compensation Task Force met to finalize its recommendations. The Task Force recommended a cash payment to living survivors of forced sterilization in the amount of $50,000. In addition, provision of mental health services for victims and educational measures to teach the history of the Eugenics Board in North Carolina were among the recommendations. A group of victims and their family members expressed disappointment in both the amount of compensation recommended and the exclusion of family members of deceased victims. The recommendations will be sent to the Governor. The legislature will ultimately be responsible for deciding what compensation, if any, is provided to victims. Unlike previous meetings of the task force, there was no time alotted for public commnet during this meeting.

Off Target, Out of Touch- HHS Oversight Committee

The Joint Health and Human Services Legislative Oversight Committee met this week. The agenda was focused on IT and database projects at the Department. In a six-hour meeting the $139 million Medicaid budget shortfall did not even make the agenda. WRAL's coverage of the meeting is here.

Disability Rights NC and other groups concerned about funding for vital Medicaid services visited the offices of legislative leadership who described the budget shortfall variously as "a cash flow problem," and "the result of mismanagement." Legislators were notified during the budget process by the Governor and advocates that the budget they set would be impossible to implement. It turns out we were right.

Disability Rights NC, together with 23 other organizations, has called on the legislature to appropriate funds to fill the gap.

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.

Health Insurance Exchange Proposed Rule Published

Yesterday, the US Department of Health and Human Services (HHS) released two long-awaited proposed rules relating to the establishment of Exchanges, state-based marketplaces where individuals and small businesses can purchase health insurance coverage. One proposed regulation sets forth the minimum functions of an Exchange and the certification of qualified health plans (QHPs) - online here. In a related proposed rule, HHS establishes a risk adjustment system to assure health care coverage for higher-risk populations - online here.


Additional regulations related to Exchanges will be issued at a later date. These future regulations will address issues including: standards for individual eligibility for participation in an Exchange, the appeals process for eligibility determinations, the definition of essential health benefits, payments of the premium tax credit, and quality standards for Exchanges and QHPs issuers.

Under the proposed rules, the marketplaces will have to post information online about price and quality, offer specific standardized plans and set an annual open enrollment period. Despite lobbying from consumer groups, insurers will be allowed to hold seats on exchange oversight boards and states will not be required to negotiate with plans on price or benefit offerings.  Although there is a deadline of Jan. 1, 2013 for states to show they will have an exchange up and running a year later, the proposal offers some wiggle room: States showing progress will be granted "conditional approval."  HHS is seeking public comment over the next 75 days.