Disability Rights NC Policy Blog

Report- NC Children with Complex Disabilities

2012-01-12T10:56:00.000-05:00

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

2012-01-10T11:08:00.001-05:00

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

2011-12-15T14:14:00.000-05:00

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

2011-11-29T11:49:00.001-05:00

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

2011-11-08T15:19:00.000-05:00

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

2011-07-12T14:19:00.000-04:00

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.

Upcoming Federal Regulations

2011-07-12T13:59:00.000-04:00

A number of federal regulatory agencies have published their Semi-Annual Regulatory Agendas. A Semi-Annual Regulatory Agenda is where the federal regulatory agencies are supposed to notify the public about their plans for regulatory actions over the next year or two. The “Timetable” dates are aspirational but informative.

From the Access Board’s Semi Annual Regulatory Agenda: It appears that a Notice for Proposed Rulemaking (NPRM) on accessible medical equipment will be published in the Federal Register fairly soon and some regulations that have had the comment period completed for some time are scheduled for publication at the end of the year.

Accessibility Guidelines for Shared Use Paths: This regulation will establish accessibility guidelines for shared use paths (typically designed for bicyclists and pedestrians and are used for recreation and transportation purposes) to ensure that they are accessible to and usable by individuals with disabilities. The guidelines are expected to be adopted as enforceable standards in separate rulemakings by the Department of Justice and the Department of Transportation for public and private entities subject to the American with Disabilities Act and Section 504 of the Rehabilitation Act, which prohibit discrimination on the basis of disability. The General Services Administration, Department of Defense, and Department of Housing and Urban Development are also expected to adopt the guidelines as enforceable standards for facilities constructed or altered with federal funds that are subject to the Architectural Barriers Act. (Advanced Notice of Proposed Rulemaking (ANPRM) 3/28/2011, Comment Period ended 6/27/2011)
Accessibility Standards for Medical Diagnostic Equipment: This regulation will establish minimum technical criteria to ensure that medical equipment used for diagnostic purposes by health professionals in (or in conjunction with) physician's offices, clinics, emergency rooms, hospitals, and other medical settings is accessible to and usable by individuals with disabilities. (NPRM projected sometime in July, 2011 and comment period ending September, 2011)
Americans With Disabilities Act (ADA) Accessibility Guidelines for Buildings and Facilities: Public Rights-of-Way: This regulation will amend the accessibility guidelines for the Americans With Disabilities Act (ADA) and the Architectural Barriers Act to include requirements for public rights-of-way. (NPRM projected July, 2011)
Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles: This regulation will revise and update the accessibility guidelines for transportation vehicles subject to the Americans With Disabilities Act. (NPRM 07/26/2010, Comment Period End 11/23/2010, Final Action projected December 2011)
Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles: Passenger Vessels: This regulation will amend the Americans With Disabilities Act (ADA) Accessibility Guidelines for Transportation Vehicles to include additional requirements for ferries, excursion boats, and other passenger vessels. (ANPRM 11/26/2004, NPRM projected December 2011)
Architectural Barriers Act (ABA) Accessibility Guidelines for Outdoor Developed Areas: This regulation will establish accessibility guidelines for outdoor developed areas designed, constructed, or altered by Federal agencies subject to the Architectural Barriers Act. (NPRM 06/20/2007, Final Action projected December 2011)
Telecommunications Act Accessibility Guidelines; Electronic and Information Technology Accessibility Standards: This regulation will revise and update the accessibility guidelines for telecommunications products subject to section 255 of the Telecommunications Act of 1996, and accessibility standards for electronic and information technology subject to section 508 of the Rehabilitation Act of 1973, as amended. (ANPRM 03/22/2010, ANPRM Comment Period End 06/21/2010, NPRM projected December 2011 )

From the HUD Semi-Annual Regulatory Agenda:

Supportive Housing for the Elderly and Persons With Disabilities: This proposed rule would amend HUD's regulations governing capital advances for the following two programs: Section 202 Supportive Housing for the Elderly and section 811 Supportive Housing for People With Disabilities. This proposed rule will provide the mixed finance regulations with more flexibility in order to attract private capital and expertise to the construction of supportive housing for the elderly and disabled. The proposed regulatory changes will streamline the use of low income tax credits as well as funding from other sources. These proposed amendments will permit the mixed finance program to expedite the development of needed affordable housing projects. NPRM projected 11/00/2011.
Multi-Family Housing Service Coordinators : This proposed rule would promulgate regulations for the Service Coordinators in multifamily housing development. Service coordinators provide assistance to elderly and disabled families in and in the vicinity of HUD-assisted rental housing developments. The regulations would establish requirements related to service coordinator qualifications, eligible funding sources, and eligible activities. NPRM projected 12/00/2011.
Affirmatively Furthering Fair Housing: This rule would provide fair housing performance standards for the requirement to affirmatively furthering fair housing. The Department seeks to foster effective fair housing strategies and to provide clear guidance to local communities, public housing agencies, and assisted housing providers to help them in their efforts to responsibly identify and solve fair housing problems, as these recipients strive to achieve equal opportunity in housing for all. To that end, the rule is intended to provide specific standards and the bases upon which these requirements would be measured--both for purposes of receiving HUD funds and to aid the Department in determining that recipients are in compliance with applicable requirements. NPRM projected 12/00/2011.
Nondiscrimination Based on Disability in Multi-Family Homeownership Projects: This rule would revise HUD's accessibility regulations applicable to multifamily homeownership projects receiving HUD federal financial assistance to achieve three primary purposes. First, the proposed rule would amend the definition of "multifamily housing project" to provide that the term includes all multifamily housing projects funded by HUD that contain five or more dwelling units regardless of whether the units are rental units or homeownership units. Second, the proposed rule would require the construction and alteration of multifamily housing projects containing homeownership units for sale to meet the same accessibility requirements as the construction and alteration of rental units. Third, the proposed rule would require that recipients selling homeownership units with accessible features undertake marketing and outreach efforts, and provide preferences to qualified persons with disabilities who need the features of the units. These proposed changes are designed to ensure that multifamily housing constructed or altered for homeownership with HUD funds includes units that have accessible features, thereby ensuring that HUD and recipients of HUD funds meet their obligations to make available affordable homeownership housing for persons with disabilities. NPRM projected 12/00/2011.
Equal Access to Housing in HUD Programs--Regardless of Sexual Orientation or Gender Identity: Through this final rule, HUD strives to ensure that its core programs are open to all Americans regardless of sexual orientation or gender identity. As the nation's housing agency, HUD programs are designed and administered to meet the national goal of a decent home and suitable living environment for every American. It is HUD's responsibility to ensure that all otherwise eligible organizations, entities, individuals, and families have equal access to HUD programs and have the opportunity to compete fairly for HUD funds without being subject to arbitrary exclusion. There is evidence, however, that lesbian, gay, and bisexual, and transgender (LGBT) individuals and families are arbitrarily excluded from some housing opportunities. NPRM 01/25/2011,NPRM Comment Period End 03/25/2011, Final Action projected 09/00/2011.
Standards Governing Harassment Under the Fair Housing Act: The proposed rule would amend HUD's Fair Housing Regulations to establish standards that the Department will use in harassment cases under the Fair Housing Act. The Department seeks to provide clear guidance for the benefit of housing consumers and providers, as well as legal practitioners for evaluating sexual harassment claims under the Fair Housing Act. NPRM projected 12/00/2011.
Implementation of the Fair Housing Act--Disparate Impact: This proposed rule would harmonize existing standards for determining when a housing practice with a discriminatory effect violates the Fair Housing Act. The proposed rule would also discuss the liability standards where a facially neutral housing practice has a discriminatory effect. NPRM projected 12/00/2011.
Economic Opportunities for Low- and Very Low-Income Persons: This proposed rule would revise HUD's regulations found at 24 CFR part 135, which ensure that employment, training, and contracting opportunities generated by certain HUD financial assistance shall, to the greatest extent feasible, and consistent with existing Federal, State, and local laws and regulations, be directed to low- and very low-income persons, particularly those who are recipients of Government assistance for housing and to business concerns that provide economic opportunities to these persons. Part 135 was last revised to incorporate the statutory amendments of the Housing and Community Development Act of 1992. This proposed rule will update part 135 to: (1) Reflect certain changes in the design and implementation of HUD programs that are subject to the section 3 regulations; (2) clarify the obligations of covered recipient agencies; and (3) simplify the Department's section 3 complaint processing procedures. NPRM projected 01/00/2012.

DOJ's Semi-Regulatory Agenda: The DOJ's timetable is usually more aspirational than most but it does appear that several items are hopefully moving in the regulatory process - e.g., the regulations to implement the revised definition of disability under the 2008 ADAAA have a deadline of November 2011. Interestingly, the deadlines for the four ADA Title II & III NPRMs on Equipment and Furniture, NextGen 9-1-1, Accessibility of Websites and Movie Captioning have been given different months for issuance of an NPRM, which may indicate that DOJ did heed the some of the commenters at the public hearings DOJ held, at which commenters urged that DOJ should move forward with the regulations that can be issued quickly and not hold up the other more contentious and difficult ones in an effort to get them all out at once. Unfortunately, the Web Accessibility NPRM has been changed to a Long Term Item and is not scheduled for publication until December 2012.

Amendments to Coordination of Enforcement of Nondiscrimination in Federally Assisted Programs and Implementation of Executive Order 12250: In 1988, the Civil Rights Restoration Act (CRRA) added definitions of "program or activity" and "program" to title VI. The added definitions were designed to clarify the broad scope of coverage of recipients' programs or activities under these statutes. In a joint rulemaking described at RIN 1190-AA49, and published in the Federal Register on August 26, 2003, the Department of Justice and other Federal agencies conformed their regulations to the CRRA. In the rulemaking described under this RIN (1190-AA52) the Department of Justice proposes to make conforming amendments to its coordination regulations concerning agency enforcement of title VI of the Civil Rights Act of 1964, 28 CFR 42.401 to 42.415. The proposed amendments explicitly incorporate the CRRA's definitions of "program or activity" and "program" into the Department's title VI coordination regulations. NPRM 09/00/2011, NPRM Comment Period End 11/00/2011
Implementation of the ADA Amendments Act of 2008: The Department of Justice is amending its regulations implementing section 504 of the Rehabilitation Act of 1973, as amended, 28 CFR part 39 and part 42, subpart G, and its regulation implementing E.O. 12250, 28 CFR part 41, to reflect statutory amendments to the definition of disability enacted in the ADA Amendments Act of 2008, Public Law 110-325, 122 Stat. 3553 (Sep. 25, 2008). The ADA Amendments Act took effect on January 1, 2009. The ADA Amendments Act revised 29 U.S.C. section 705, to make the definition of disability used in the nondiscrimination provisions in title V of the Rehabilitation Act consistent with the amended ADA requirements. These amendments (1) Add illustrative lists of "major life activities," including "major bodily functions," that provide more examples of covered activities and covered conditions than are now contained in agency regulations (sec. 3[2]); (2) clarify that a person who is "regarded as" having a disability does not have to be regarded as being substantially limited in a major life activity (sec. 3[3]); and (3) add rules of construction regarding the definition of disability that provide guidance in applying the term "substantially limits" and prohibit consideration of mitigating measures in determining whether a person has a disability (sec. 3[4]). The Department anticipates that these changes will be published for comment in a proposed rule within the next 12 months. During the drafting of these revisions, the Department will also review the currently published rules to ensure that any other statutory changes in the Rehabilitation Act have been properly addressed in these regulations. NPRM projected 11/00/2011.
Implementation of the ADA Amendments Act of 2008 (Title II and Title III of the ADA): The Department of Justice is amending its regulations implementing title II and title III of the Americans with Disabilities Act (ADA), 28 CFR part 35 and 28 CFR part 36, to implement changes to the ADA enacted in the ADA Amendments Act of 2008, Public Law 110-325, 122 Stat. 3553 (Sept. 25, 2008). The ADA Amendments Act took effect on January 1, 2009. The ADA Amendments Act amended the Americans With Disabilities Act, 42 U.S.C. 12101, et seq., to clarify terms within the definition of disability and to establish standards that must be applied to determine if a person has a covered disability. These changes are intended to mitigate the effects of the Supreme Court's decisions in Sutton v. United Airlines, 527 U.S. 471 (1999), and Toyota Motor Manufacturing v. Williams, 534, U.S. 184 (2002). Specifically, the ADA Amendments Act (1) Adds illustrative lists of "major life activities," including "major bodily functions," that provide more examples of covered activities and covered conditions than are now contained in agency regulations (sec. 3[2]); (2) clarifies that a person who is "regarded as" having a disability does not have to be regarded as being substantially limited in a major life activity (sec. 3[3]); and (3) adds rules of construction regarding the definition of disability that provide guidance in applying the term "substantially limits" and prohibit consideration of mitigating measures in determining whether a person has a disability (sec. 3[4]). NPRM projected 11/00/2011.
Nondiscrimination on the Basis of Disability by State and Local Governments and Places of Public Accommodation; Equipment and Furniture: Title II of the ADA applies to services, programs, or activities of public entities within the meaning of 42 U.S.C. 12133(1)(A). The program accessibility requirement of title II mandates public entities to operate each service, program, or activity so that, when viewed in its entirety, the service, program, or activity is readily accessible to and usable by individuals with disabilities, subject to a defense of fundamental alteration or undue burden (28 CFR 35.150[a]). Section 35.150(b) specifies that such entities may meet their obligation to make each program accessible to individuals with disabilities through the "redesign of equipment." Title II entities also must ensure that communications with individuals with disabilities are as effective as communications with others and provide appropriate auxiliary aids and services where necessary to ensure that individuals with disabilities have an equal opportunity to participate in and benefit from a service, program, or activity (28 CFR 35.160). Title III of the ADA applies to persons who own, lease or lease to, or operate places of public accommodation (42 U.S.C. 12182[a]). Public accommodations discriminate against individuals with disabilities when they enact discriminatory policies or practices, or fail to remove barriers or make requested reasonable modifications in order to accommodate an individual's disability, unless barrier removal is not readily achievable or a modification would fundamentally alter the nature of the business (see 28 CFR 36.304 [barrier removal] and 36.302[a][reasonable modification]). Public accommodations also must ensure that no individuals with disabilities are excluded, denied services, segregated or otherwise treated differently from other individuals because of the absence of auxiliary aids and services, unless taking such steps would fundamentally alter the nature of the goods, services, facilities, privileges, advantages, or accommodations being offered or result in an undue burden (28 CFR 36.303[a]). Some types of equipment and furniture are covered specifically by the Department's adoption of the 1991 ADAAG as the ADA Standards for Accessible Design. Equipment and furniture may also be covered by other regulatory provisions including reasonable modifications, 28 CFR 36.302; auxiliary aids, 28 CFR 36.303; and barrier removal, 28 CFR 36.304. While some types of fixed equipment and furniture are explicitly covered by the 1991 Standards, there are no specific provisions in the regulations governing the accessibility of equipment and furniture that are not fixed. See 28 CFR pt. 36, app. A. (Automatic Teller Machines (ATMs) and Fixed or Built-in Seating or Tables). To the extent that the ADA standards apply requirements for fixed equipment and furniture, the Department will look to those standards for guidance on accessibility standards for equipment and furniture that are not fixed. Accessible equipment and furniture is often critical to an entity's ability to provide a person with a disability equal access to its services. Changes in technology have resulted in the development and improved availability of accessible equipment and furniture that benefit individuals with disabilities. Consequently, it is easier now to specify appropriate accessibility standards for such equipment and furniture, as the Access Board has done for several types of fixed equipment and furniture, including ATMs, washing machines, dryers, tables, benches, and vending machines. See sections 903, 902, 707, 611, and 228 of the ADA/ABA Accessibility Guidelines. ANPRM 07/26/2010, ANPRM Comment Period End 01/24/2011, NPRM projected 12/00/2011.
Nondiscrimination on the Basis of Disability in State and Local Government Services; Next Generation 9-1-1: In 1991, the Department of Justice published a regulation to implement title II of the Americans With Disabilities Act of 1990 (ADA). That regulation includes the requirement that public safety answering points (PSAPs) provide direct access to persons with disabilities who use analog telecommunication devices for the deaf (TTYs). 28 CFR 35.162. On July 26, 2010, the Department published an advance notice of proposed rulemaking (ANPRM) to address in what manner PSAPs should be required to make changes in communication technology to reflect developments that have occurred since the publication of the 1991 regulation. Many individuals with disabilities now use the Internet and wireless text devices as their primary modes of telecommunications. At the same time, PSAPs are considering and planning to shift from analog telecommunications technology to new Internet-Protocol (IP)-enabled Next Generation 9-1-1 services (NG 9-1-1) that will provide voice and data (such as text, pictures, and video) capabilities. This ANPRM seeks information on possible revisions to the Department's regulation to ensure direct access to NG 9-1-1 services for individuals with disabilities.ANPRM 07/26/2010, ANPRM Comment Period End 01/24/2011, NPRM 09/00/2011.
Nondiscrimination on the Basis of Disability; Accessibility of Web Services of State and Local Government Entities and Public Accommodations: The Department of Justice is considering proposed revisions to the regulations implementing Title III of the Americans with Disabilities Act (ADA) in order to provide specific guidance on the obligations of public accommodations to make goods, services, facilities, privileges, accommodations, or advantages they offer via the Internet, specifically at sites on the World Wide Web (Web), accessible to individuals with disabilities. The Department is also considering revising the ADA's Title II regulations to provide specific guidance on the obligations of public entities to make services, programs, or activities offered to the public via the Web accessible. ANPRM 07/26/2010, ANPRM Comment Period End 01/24/2011, NPRM 12/00/2012.
Nondiscrimination on the Basis of Disability; Movie Captioning and Video Description: On July 26, 1991, the Department of Justice published a final rule implementing title III of the Americans with Disabilities Act of 1990 (ADA). Title III prohibits discrimination on the basis of disability in the activities of places of public accommodation (private entities whose operations affect commerce and that fall into one of twelve categories listed in the ADA, such as restaurants, movie theaters, schools, day care facilities, recreational facilities, and doctors' offices) and requires newly constructed or altered places of public accommodation-as well as commercial facilities (privately owned, nonresidential facilities such as factories, warehouses, or office buildings)-to comply with the ADA Standards (42 U.S.C. 12181–89). Title III makes it unlawful for places of public accommodation, such as movie theaters, to discriminate against an individual in the full and equal enjoyment of the goods, services, facilities, privileges, advantages, or accommodations of a place of public accommodation (42 U.S.C. 12182[a]). Moreover, title III prohibits places of public accommodation from affording an unequal or lesser service to individuals or classes of individuals with disabilities than is offered to other individuals (42 U.S.C. 12182(b)(1)(A)(ii)). Title III requires places of public accommodation to take "such steps as may be necessary to ensure that no individual with a disability is excluded, denied services, segregated or otherwise treated differently because of the absence of auxiliary aids and services, unless the entity can demonstrate that taking such steps would fundamentally alter the nature of the good, service, facility, privilege, advantage, or accommodation being offered or would result in an undue burden," (42 U.S.C. 12182(b)(2)(A)(iii)). The statute defines auxiliary aids to include "qualified interpreters or other effective methods of making aurally delivered materials available to individuals with hearing impairments" and "taped texts, or other effective methods of making visually delivered materials available to individuals with visual impairments," (42 U.S.C. 12103(1)(A)-(B)). The Department's title III regulation specifically lists open and closed captioning and audio recordings and other effective methods of making aurally and visually delivered materials available to individuals with hearing and visual impairments as examples of auxiliary aids and services that should be provided by places of public accommodations, 28 CFR 36.303(b)(1)-(2), unless the public accommodation can demonstrate that providing such aids and services would fundamentally alter the nature of the good or service being offered or would result in an undue burden (28 CFR 36.303(a)). Because, in pertinent part, the legislative history of title III stated that "[o]pen-captioning of feature films playing in movie theaters, is not required by this legislation," H.R. Rep. No. 101-485 (II), at 108 (1990), S. Rep. No. 101-116 at 64 (1989), the Department stated in its 1991 rule that "[m]ovie theaters are not required to present open-captioned films," 56 FR 35544, 35567 (July 26, 1991). The Department was silent regarding closed captioning and video description in movie theaters. The Department noted, however, that "other public accommodations that impart verbal information through soundtracks on films, video tapes, or slide shows are required to make such information accessible to persons who are deaf or hard of hearing. Captioning is one means to make the information accessible to individuals with disabilities." Since 1991, there have been many technological advances in the area of closed captioning and video description for first-run movies. In the legislative history of the ADA, the House Committee stated that "technological advances can be expected to further enhance options for making meaningful and effective opportunities available to individuals with disabilities" and that "[s]uch advances may require public accommodations to provide auxiliary aids and services in the future which today would not be required because they would be held to impose undue burdens on such entities." H.R. Rep. No. 101-485 (II), at 108. On June 17, 2008, the Department issued a Notice of Proposed Rulemaking (NPRM) to adopt the revised ADA Standards and, in pertinent part, revise the title III regulation. 73 FR 34508. In that NPRM, the Department stated that it was considering options under which it might require that movie theater owners or operators exhibit movies that are captioned for patrons who are deaf or hard of hearing and movies that provide video (narrative) description for patrons who are blind or have low vision. The Department received numerous comments urging the Department to issue captioning and video description regulations under the ADA. Rather than using these comments to formulate a final rule, however, the Department decided to issue a supplemental ANPRM for three main reasons. First, the Department wished to obtain more information regarding several issues raised by commenters that were not contemplated at the time the 2008 NPRM was published. Second, the Department sought public comment on several technical questions that arose from the research the Department undertook to address some of the issues raised by commenters to the original NPRM. Finally, in the two years that have passed since issuance of the 2008 NPRM, the Department was aware that movie theater owners and operators, particularly major movie theater owners and operators, either have entered into, or had plans to enter into, agreements to convert to digital cinema. However, during this same time period, the United States' economy, and the profitability of many public accommodations, experienced significant setbacks. The Department wished to learn more about the status of digital conversion, concrete projections regarding if and when movie theater owners and operators, both large and small, expected to exhibit movies using digital cinema, when such movie theater owners and operators expected to implement digital cinema, by percentages, in their theaters, and any relevant protocols, standards, and equipment that have been developed regarding captioning and video description for digital cinema. In addition, the Department sought information regarding whether, in the last two years, other technologies or areas of interest (e.g., 3D) have developed or are in the process of development that either would replace or augment digital cinema or make any regulatory requirements for captioning and video description more difficult or expensive to implement.ANPRM 07/26/2010, ANPRM Comment Period End 01/24/2011, NPRM 10/00/2011.

Department of Transportation Semi-Annual Regulatory Agenda

Transportation for Individuals with Disabilities--Miscellaneous Amendments: This rulemaking would amend several regulations regarding rail station platform standards, reasonable modifications of policies and procedures, and pedestrian access; it would also codify existing DOT procedures for issuing interpretations and guidance. NPRM Comment period 2006, Final Rule projected 08/00/2011.
Carrier-Supplied Medical Oxygen, Service Animals, and Accessibility of Carrier Websites, Kiosks, and In-Flight Entertainment Systems: This rulemaking would fulfill a commitment made in the final rule amending the Air Carrier Access Act rules to develop an SNPRM seeking information from the public on: (1) the cost and technical issues involved in requiring carrier website accessibility; (2) whether automated kiosks operated by carriers in airports and elsewhere should be required to be accessible; (3) whether there are safety-related reasons for excluding service animals other than dogs that may be specific to foreign carriers; (4) whether the cost of requiring carriers to supply free in-flight medical oxygen would create an undue burden; and (5) whether providing high-contrast captioning on in-flight entertainment displays is technically and economically feasible. Supplemental NPRM 07/00/2011.

Final 2011 Budget Summary Posted & Special Session Schedule Update

2011-07-07T11:28:00.000-04:00

Final Budget Summary is on our website here and all of the bill reports are here.

Special Session
It appears that the House and Senate have set a schedule for the special session at the end of this month:
The Senate will gavel in at noon on Wednesday, July 13, and then hold three skeleton sessions until the full chamber reconvenes Monday, July 25.
The House plans to meet July 13, and then adjourn until Friday, July 22.
Meanwhile, the House and Senate redistricting committees will hold tag team meetings from the morning of Thursday, July 21, through the evening of Saturday, July 23.
Both chambers plan to pass an adjournment resolution on Thursday, July 28.
Note: There will be a Respect & Protect The Vote Rally on July 13 at 11 am at the General Assembly. You can find a flyer about the event here.

During the special session, will be watching closely:
Their consideration of election laws and possible veto override votes on the following: HB 351, Voter ID; SB 496, Medicaid & Health Choice Provider Requirements; and SB 781, Regulatory Reform Act of 2011; as well as bills being considered in conference committees between the chambers, including HB 773, the Studies Act.

Final Bill Reports Posted on Disability Rights NC website

2011-07-05T16:23:00.000-04:00

Final reports on legislation related to people with disabilities has been posted to our website. The reports include legislation passed as well as bills introduced but not passed, and are broken down into the following categories: Accessibility and Employment; Administrative Law and Rulemaking; Adult Corrections, Ex-Offenders and Law Enforcement; Education and Juvenile Justice; Healthcare and Residential Facilities; Healthcare (including MH/DD/SAS); Housing; Law Practice; Voting Access; and Miscellaneous.

Bill Update for the Week of June 13

2011-06-22T14:59:00.002-04:00

The House and the Senate voted to override the Governor’s veto of the budget last week and then spent long days in committee and in session in order to adjourn on Saturday. The following is a summary of bills acted upon last week. Full reports on all of the bills of interest to people with disabilities will be posted soon, along with a final budget summary.

HB 229, Rural Operating Assistance Program Changes (Owens Sponsor). HB 229 will allow regional public transportation authorities, upon written agreement with the counties, to apply for Elderly and Disabled transportation and assistance funds to which the member counties are entitled to receive. The bill was approved by the Senate without changes last week and has been presented to the Governor for her signature.

HB 344, Tax Credits for Children with Disabilities (Stam, Randleman, Jordan and Jones Sponsors). The bill creates an individual income tax credit for families of children with disabilities who require special education and are attending a nonpublic school, including home school. The credit is equal to the amount the taxpayer paid for tuition and special education and related services expenses, not to exceed three thousand dollars ($3,000) per semester. It also creates a Fund for Special Education and Related Services, with $2,000 per tax credit given being transferred to the Fund each year. Last week, this legislation was approved by the Senate, and the House concurred with the changes made in the Senate. It will now proceed to the Governor.

HB 351, Restore Confidence in Government (Lewis, Moore and Killian Sponsors). HB351, aka the “Voter ID” bill will require photo identification before voting. The bill as passed removed all of the compromise language discussed earlier in the session, including the exceptions for people with disabilities. The Senate Judiciary I and Appropriations committees approved the bill last week, and the House concurred in the Senate committee substitute. The bill has now been presented to the Governor and it is hoped that she will veto the legislation.

HB 374, Eugenics Records/Public Records Exemption (Womble and Parmon Sponsors). The bill makes clear that records in the custody of the State concerning the North Carolina Eugenics Board program are not public records to the extent they concern: (i) persons impacted by the program, (ii) persons or their guardians or authorized agents inquiring about the impact of the program on them, (iii) persons or their guardians or authorized agents inquiring about the potential impact of the program on others. It also states that a person impacted by the program may obtain that person's individual records under the program, and a guardian or authorized agent of that person may also obtain them. The bill was approved by the Senate and ratified by the House last week and has been presented to the Governor.

HB 397, DHHS Penalties and Remedies Revision (Lewis Sponsor). HB 397 seeks to amend facility penalty provisions under 122C, 131D and 131E to split Type A violations into Type A1 (violations that result in result in death or serious physical harm, abuse, neglect, or exploitation) and Type A2 violations (violations that result in substantial risk that death or serious physical harm, abuse, neglect, or exploitation will occur). HB 397 is now a consensus bill that passed through the House last month. HB 397 was approved by the Senate Finance committee where some technical corrections to the bill were made, followed by approval by the full Senate. The House concurred in the Senate committee substitute and the bill has been presented to the Governor.

HB 509, Exclusions from Licensure: Home Services (Hurley Sponsor). HB 509 seeks to allow people with disabilities who receive MH/DD/SA services to live together as roommates without their home being considered a facility for licensing purposes. Specifically, it excludes from licensure: “A home in which up to three adults, two or more having a disability, co own or co rent a home in which the persons with disabilities are receiving three or more hours of day services in the home or up to 24 hours of residential services in the home. The individuals who have disabilities cannot be required to move if the individuals change services, change service providers, or discontinue services.” Disability Rights NC was part of the workgroup that developed this language, and we support this bill. HB 509 was approved by the full Senate last week and has been presented to the Governor.

HB 595, Reorganization/Legislative Oversight Comns (Barnhart, Burr Sponsors). HB 595 proposes a new structure for the numerous legislative committees and commissions, including establishing a Joint Legislative Oversight Committee on Health and Human Services, which merges the Study Commission on Aging, the Joint Legislative Health Care Oversight Committee, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, and the Public Health Study Commission. Last week, the House concurred with the changes made in the Senate and the bill has been presented to the Governor.

HB 618, Streamline Oversight/DHHS Service Providers (Lewis and Hurley Sponsors). HB 618 seeks to streamline duplicate oversight of DHHS service providers. A very scaled back version of the bill was approved by the Senate last week. The bill no longer includes a task force to make recommendations on duplicative oversight. The bill now directs DHHS to: prepare a rate setting memorandum for every change or adjustment made by DHHS in service definition, policy, rule, or provider requirements that impacts services; dissolve North Carolina Treatment Outcomes Program Performance System (NC TOPPS) Advisory Committee and establish a task force made up of division staff, Behavioral Health Managed Care Organizations, consumers, and providers to objectively evaluate the North Carolina Treatment Outcomes Program Performance System (NC TOPPS) to improve the way data is accessible across services rather than site specific to reflect valid comparisons of program outcomes by August 1, 2011; allow private sector development and implementation of an Internet based, secure, and consolidated data warehouse and archive for maintaining corporate, fiscal, and administrative records of providers by September 1, 2011; and review on an annual basis updates to policy made by national accrediting bodies and take actions necessary to ensure that DHHS policy or procedural requirements do not duplicate the updated accreditation standards. The House concurred in the Senate committee substitute and the bill has been presented to the Governor.

HB 622, Nursing Homes/Food Service Inspections (McCormick, Stevens, Cleveland, Glazier Sponsors), was previously titled “Article 3A Administrative Procedures.” The bill now seeks to allow nursing homes and nursing home beds licensed under Chapter 131E that are also certified by Medicare and Medicaid to be limited to one food service inspection per year unless the facility receives a grade "B" or lower on its annual inspection. It was approved by the Senate last week and has been presented to the Governor.

HB 646, Prison Hospital Completion (Daughtry Sponsor). The bill allows the Department of Correction to use funds allocated for 2 capital projects that came in under budget to finish the hospital at Central Prison (funds will be used to finish the facility, purchase medical equipment, and expand the kitchen). The prison hospital will have 120 beds and will include beds for inmates with psychiatric needs. The bill was approved by the full Senate last week and has been presented to the Governor.

HB 677, Discharge of Adult Care Home Residents (Lewis). HB 677 seeks to change the law governing Adult Care Home discharge of residents. A committee substitute which made several changes was approved by the Senate last week. The bill now places the responsibility for determining an appropriate discharge destination on the local adult care home discharge team members, rather than on the Division of Medical Assistance Hearing Unit. It also adds that the Department cannot prohibit discharge solely for the reason that the discharge destination identified in the written notice does not include an appropriate discharge destination. However, the discharge team must provide the Hearing Unit with the discharge location at or before the discharge hearing. It also now provides that LMEs shall take the lead role for the discharge destination for residents whose primary unmet needs are related to MH/DD/SA and local departments of social services shall take the lead role for those residents whose primary unmet needs are related to health, including Alzheimer's disease and other forms of dementia, welfare, abuse, or neglect. Finally, the legislation now states that the resident shall remain in the facility pending appeal unless (1) The discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility as documented by the resident's physician, physician assistant, or nurse practitioner;(2) The safety of other individuals in the facility is endangered; and (3) The health of other individuals in the facility is endangered as documented by a physician, physician assistant, or nurse practitioner. The full Senate approved the bill, the House concurred in the Senate committee substitute and it has now been presented to the Governor.

HB 678, Pilot Release of Inmates to Adult Care Homes (Lewis Sponsor). HB 678 seeks to establish a pilot program to allow certain inmates released from confinement to be placed in an Adult Care Home (only the inmates selected for the pilot will reside in the facility) to receive Personal Care Services and Medication Management. HB 678 was approved by the Senate and ratified by the House, and has now been presented to the Governor.

HB 736, Amend Law re: School Discipline (Langdon, Luebke, Daughtry, Lucas Sponsors). HB 736 seeks to make a number of changes to Chapter 115C regarding school discipline with the goal of keeping students in school. It is a consensus bill supported by Disability Rights NC that numerous entities representing schools and students contributed to. The conference committee appointed on the bill agreed to incorporate the Corporal Punishment opt-out language of SB 498 into HB 736. To avoid any confusion regarding the new 115C section numbers, the bill also specifies that if Senate Bill 498 becomes law, then that act is repealed. The House and the Senate approved the conference committee report and the bill has now been presented to the Governor.

HB 773, Studies Act of 2011 (Johnson, Murry, McGee, Starnes, Dockham Sponsors). The Senate approved a committee substitute for the study bill but the House did not concur. A conference committee was appointed but did not have time to meet in the rush of the end of the session. However, they may take up the bill during the special session beginning July 13. The current version contains numerous items that may be studied that are relevant to people with disabilities, including: criminal defendants who lacks the capacity to proceed to trial; in home and community based mental health services for youth; a bill of rights for children who are deaf or hearing impaired; a revised process for collecting data to develop a waiting list of persons with intellectual or developmental disabilities; a pilot program to evaluate the costs, quality, consumer satisfaction, and patient outcomes of a program that supports individuals who are in an adult or family care home and who want to move back into independent supported housing; short and intermediate term options for improving economies and efficiencies in the provision of aid and services under the Medicaid plan with respect to services for Medicaid beneficiaries requiring long term care services, including beneficiaries who are aged, blind, and disabled, and those dually eligible for Medicaid and Medicare. Again, the bill has not yet been approved, and, even when it has been, there is no guarantee that any of these issues will be studied.

HB 808, Revise Laws on Adult Care Homes (Burr). HB 808 seeks to waive annual inspections of Adult Care Homes that achieve the highest rating, and to develop an informal dispute resolution procedure that allows Adult Care Homes to dispute cited inspection deficiencies. The full Senate approved the bill last week, the House concurred in the Senate committee substitute, and it has now been presented to the Governor.

SB 8, No Cap on Number of Charter Schools (Stevens sponsor). This bill eliminates the existing cap of 100 charter schools. This bill has been in conference between the House and Senate for the past 2 months. The conference committee reported in this week. The legislation now simply lifts the cap on charter schools. The compromise agreement removes the current limit of 100 charters and allows existing schools to increase annual enrollment by 20 percent. The conference report scraps some of the more controversial provisions - including one that would have granted broader authority to an independent charter board to approve new schools. The latest version also no longer requires charters to provide transportation or free and reduced lunches to low-income students. The Governor signed the bill into law last week and it is now Session Law 2011 164.

SB 375, Facilitate Statewide Health Info. Exchange (Stein and Brunstetter Sponsors). SB 375 seeks to set up a statewide health information exchange network. The framework proposed is to facilitate the exchange of healthcare information among covered healthcare providers within the confines of HIPAA. It allows individuals the right to opt out if they so choose. The provisions proposed only apply to protected health information disclosed within the Health Information Exchange. A House committee substitute was approved last week, which added a requirement for individual notice of the right to opt out (not just public notice). The Senate concurred in the House committee substitute and the bill has been presented to the Governor.

SB 394, Clarify Process/Reportable Offenses in Schools (Newton, Tillman, Preston Sponsors). SB 394 seeks to amend the statute (115C-288(g)) regarding principal reporting of certain acts to law enforcement. It proposes to change the standard from a principal’s “personal knowledge or actual notice from school personnel” to “reasonable belief” (which is further defined) that a specified act has occurred on school property. It also provides that the State Board of Education shall not require the principal to report to law enforcements acts in addition to those required in the statute. Last week, SB 394 was approved by the House, ratified by the Senate, and presented to the Governor.

SB 397, Expunge Nonviolent Offense by Minor (Berger, McKissick, Daniel Sponsors). SB 397 will allow the expunction of criminal records for certain offenses for first offenders who are under 18 years of age at the time of the commission of a nonviolent felony. Last week, a House committee substitute was approved by the House, the Senate concurred in the committee substitute, and the bill has been presented to the Governor.

SB 437 Enact First Evaluation Program (Hartsell Sponsor). SB 437 seeks to codify a practice that has been piloted that allows the Secretary to waive the requirements for a physician or eligible psychologist to perform the initial examination for involuntary commitment and substitute a licensed clinical social worker, a master's level psychiatric nurse, or a master's level certified clinical addictions specialist at the request of an LME. When making and considering the request, certain criteria must be addressed. A House committee substitute was approved by the House last week; the Senate concurred in the Senate committee substitute; and the bill has been presented to the Governor.

SB 449, Task Force on Fraud Against Older Adults (Bingham Sponsor). SB 449 directs the Consumer Protection Division of the NC Department of Justice, to coordinate a task force on fraud against older adults, as recommended by the North Carolina Study Commission on Aging. The bill was approved by the House and ratified by the Senate last week, and it has now been presented to the Governor.

SB 474, Photo ID for Certain Controlled Substances (Apodaca, Hise Sponsors). SB 374 seeks to direct pharmacies to require photo identification prior to dispensing any Schedule II and certain Schedule III Controlled Substances. A committee substitute was passed by the House last week; the Senate concurred; and the bill has been presented to the Governor.

SB 479, Testing in the Public Schools (Tillman, Preston, Soucek Sponsors). SB 479 seeks to implement several additional components of the state’s testing of public school students: continued participation in the development of the Common Core State Standards in conjunction with the consortium of other states, including implementing the assessments that the State Board deems most appropriate to assess student achievement on the Common Core State Standards; to the extent funds are made available, the State Board shall plan for and require the administration of the ACT test for all students in the eleventh grade unless the student has already taken a comparable test and scored at or above a level set by the State Board, as well as diagnostic tests in the eighth and tenth grades that align to the ACT test in order to help diagnose student learning and provide for students an indication of whether they are on track to be remediation free at a community college or university; and to the extent funds are made available for this purpose, the State Board shall plan for and require local school administrative units to make available the appropriate WorkKeys tests for all students who complete the second level of vocational/career courses. A committee substitute was approved by the House last week; the Senate concurred; and the bill has been presented to the Governor.

SB 496, now known as Medicaid and Health Choice Provider Req (was PPACA/Required Fraud and Abuse Provisions) (Pate Sponsor). SB 496 seeks to implement screening for Medicaid and Health Choice providers, identifying providers of certain types of services as low, moderate or high risk. It also provides for criminal history record checks for certain providers. It also amends the procedures for changing medical policies. Last week, the House approved a committee substitute; the Senate concurred; and the bill has been referred to the Governor.

SB 498, Modify Law re: Corporal Punishment (Pate, Purcell Sponsors). SB 498 would allow parents to opt their child out of a school’s corporal punishment policy. An amendment to the bill was adopted in the House that added language stating that the form given to parents shall advise that the student may be subject to suspension, among other possible punishments, for offenses that would otherwise not require suspension if corporal punishment were available. Although the bill was approved by both the House and the Senate, the approved language was incorporated into the school discipline bill mentioned above, which also directed the repeal of this bill if enacted.

SB 578, Facilitate Transfer SPH Beds Com. Facility (Hartsell) was formerly titled “LME Minimum Population.” SB 578 now seeks to allow the Secretary of DHHS to transfer beds from a State psychiatric hospital to a community facility without a written memorandum of agreement between the local management entity serving the county where the beds are to be located and the facility submitting the proposal if certain conditions are met, including that the facility submits a CON application, the facility commits to serve the type of short term patients normally placed at the State psychiatric hospital, the facility proposing to operate the beds is a provider created under G.S. 131E 17 and the facility proposing to operate the beds is in a single county area authority. The bill is intended to fix an issue in the Mecklenburg catchment area that has prevented the transfer of beds from Broughton to the Carolinas Medical Center (the beds at Broughton are un-staffed so this will not decrease, but rather increase, available beds). It was approved by the House last week, ratified by the Senate, and has been presented to the Governor.

SB597 (Purcell) BEHAVIORAL HEALTH SERVICES FOR MILITARY/FUNDS. SB 597 would require LMEs and schools to make certain staffing and procedural changes to ensure care for members of the military, veterans, and their families, whose care is funded through federal programs is coordinated appropriately. The bill was approved by the House, ratified by the Senate and presented to the Governor. It was signed into law this week and is SL2011-0185.

SB 607, Conform Medical Record Laws (Stein). SB 607 seeks to amend various sections in the General Statutes to make it easier to share currently protected health information, including a provision seeking to revise exceptions to confidentiality under 122C, which covers MH/DD/SA service providers. The House approved a committee substitute last week that the Senate concurred with. It has been presented to the Governor. The House committee substitute strengthened the language in the 122C section to add the client’s legally responsible person and to add that the person may object in writing or sign a non disclosure form that shall be supplied by the facility.

SB 683, Residential Building Inspections (Hunt Sponsor). SB 683 seeks to limit the allowable periodic building inspections only when there is reasonable cause to believe that unsafe, unsanitary, or otherwise hazardous or unlawful conditions may exist in a residential building. It was approved by the Senate and the House, and has been presented to the Governor.

SB 781, Regulatory Reform Act of 2011 (Rouzer and H. Brown, Sponsors). SB 781 amends Chapter 150B of the NC general statutes to add requirements for agencies in rulemaking, and analysis of the fiscal impact of rules. It also incorporates changes regarding final agency decision-making authority supported by Disability Rights NC. It was approved by the House and Senate and has been sent to the Governor.

And they're gone . . . for now

2011-06-20T14:44:00.000-04:00

Just a quick note for you folks who follow the DRNC Policy blog . . . The legislature has adjourned until July 13. At that time, they will return to take up redistricting; bills vetoed by the Governor (which is a growing list); Filling of vacancies on the State Board of Community Colleges; Bills in which the General Assembly makes an appointment or appointments to public office and which contain no other matter; Bills relating to election laws; and adoption of conference reports for bills which were in conference as of Saturday, June 18, 2011 and conferees had been appointed by both houses as of that date.

A summary of what happened the last week of session and a final summary of the budget will be posted here in the coming days. Soon thereafter, we hope to have final legislative reports on all bills we have been tracking available on the website. If you have a burning desire to know how something turned out before then, please contact me at annaliese.dolph@disabilityrightsnc.org.

Bill Update for the Week of June 6

2011-06-12T11:52:00.000-04:00

There was a flurry of activity this week at the General Assembly as we hit the crossover deadline, Thursday, June 9 and both chambers attempt to wrap up by the end of next week. Crossover is the date by which (most) bills need to pass at least one chamber in order to be eligible to proceed. Crossover is usually much earlier in the session. With the number of bills flying through last week, this next week is sure to bring long hours and lots of debate. Many bills will be considered for final passage but some legislation will be tabled until the short session next year.

We are also awaiting action from the Governor on the budget. She has until June 14 to act. The expectation remains that the Governor will veto the budget, the House and Senate will override her veto and the budget will be finalized in the coming week as well. As there are always some tweaks to the budget in what’s called the “Technical Corrections” bill in the final days of the session, we are holding off on our full budget summary until then. However, the blog has reports summarizing the budget in earlier posts.

HB 229, Rural Operating Assistance Program Changes (Owens Sponsor). HB 229 will allow regional public transportation authorities, upon written agreement with the counties, to apply for Elderly and Disabled transportation and assistance funds to which the member counties are entitled to receive. The bill received a favorable report from the House Transportation committee this week, as well as a successful vote from the full House. It has been referred to the Senate Transportation committee.

HB 237, Economic Impact/Regulatory Legislation (Dollar, Rhyne, McElraft, Folwell Sponsors). HB 237 seeks to require economic impact statements on all bills that propose regulatory changes, similar to the fiscal notes that agencies prepare during rulemaking. HB 237 received a favorable report from the House Commerce committee last week, and passed the full House. It has been referred to the Senate Commerce committee.

HB 344, Tax Credits for Children with Disabilities (Stam, Randleman, Jordan and Jones Sponsors). The bill creates an individual income tax credit for families of children with disabilities who require special education and are attending a nonpublic school, including home school. The credit is equal to the amount the taxpayer paid for tuition and special education and related services expenses, not to exceed three thousand dollars ($3,000) per semester. It also creates a Fund for Special Education and Related Services, with $2,000 per tax credit given being transferred to the Fund each year. A committee substitute that tacked on changes to the budget bill regarding education appropriations and funds to the Savings Reserve Account, received a favorable report from the House Appropriations committee this week. The bill then proceeded to a vote in the full House, passing 73-39 after 3 amendments were considered. The first amendment, made by Representative Daughtry, which was adopted, amended the section that made the tax credit refundable to intead allow for carryover. The second amendment, made by Representative Goodman, would have limited the students covered by the bill to students with mental retardation or with multiple disabilities who are served in a regular classroom 40% or less during the day, but it failed. The third amendment, made by Representative Brandon, amended the disqualification portion of the bill to allow students up to age 22, rather than 19, to qualify. The bill is scheduled to be heard in the Senate Education committee on Monday.

HB 351, Restore Confidence in Government (Lewis, Moore and Killian Sponsors). HB351, aka the “Voter ID” bill will require photo identification before voting. Voter ID voted out of Appropriations. The bill considered this week removes all of the compromise language discussed earlier in the session – must have NC driver’s license, US passport, military ID, . There are no exceptions for people with disabilities. Bryant moved to amend the bill on the floor. Jackson spoke about HAVA documents – will reduce access. Rep Killian rejects the idea that it is burdensome to get an idea –obviously he doesn’t know anyone with a disability who lacks access to transportation! The bill passed the House along strict party lines. The bill will next be considered in the Senate Judiciary I committee.

HB 374, Eugenics Records/Public Records Exemption (Womble and Parmon Sponsors). The bill makes clear that records in the custody of the State concerning the North Carolina Eugenics Board program are not public records to the extent they concern: (i) persons impacted by the program, (ii) persons or their guardians or authorized agents inquiring about the impact of the program on them, (iii) persons or their guardians or authorized agents inquiring about the potential impact of the program on others. It also states that a person impacted by the program may obtain that person's individual records under the program, and a guardian or authorized agent of that person may also obtain them. HB 374 received a favorable report from the Senate Judiciary II committee last week and is scheduled to be voted upon by the full Senate on Monday.

HB 397, DHHS Penalties and Remedies Revision (Agency Bill) (Lewis Sponsor). HB 397 seeks to amend facility penalty provisions under 122C, 131D and 131E to split Type A violations into Type A1 (violations that result in result in death or serious physical harm, abuse, neglect, or exploitation) and Type A2 violations (violations that result in substantial risk that death or serious physical harm, abuse, neglect, or exploitation will occur). HB 397 is now a consensus bill that passed through the House last month. It received a favorable report from the Senate Health Care committee last week, and will next be heard in Senate Finance where some technical corrections to the bill are expected before being voted upon in the full Senate.

HB 467, as originally filed, (Blust Sponsor) sought to amend the current law related to the use of reasonable force in schools to allow reasonable force to be used for discipline purposes and to make it even more difficult to hold school personnel liable for excessive force. The bill was changed this week to a bill to Restructure the Guilford County Board of Commissioners. Disability Rights NC was opposed to the original bill. As there was no Senate counterpart, the matter will not procced.

HB 509, Exclusions from Licensure: Home Services (Hurley Sponsor). HB 509 seeks to allow people with disabilities who receive MH/DD/SA services to live together as roommates without their home being considered a facility for licensing purposes. Specifically, it excludes from licensure: “A home in which up to three adults, two or more having a disability, co own or co rent a home in which the persons with disabilities are receiving three or more hours of day services in the home or up to 24 hours of residential services in the home. The individuals who have disabilities cannot be required to move if the individuals change services, change service providers, or discontinue services.” Disability Rights NC was part of the workgroup that developed this language, and we support this bill. HB 509 received a favorable report from the Senate Health Care committee last week and will be voted upon in the full Senate on Monday. This is the last stop before proceeding to the Governor to be signed into law.

HB 541 was originally filed as CAP-MR/DD Waiver Change/Residential Supports (Hurley Sponsor) and would have allowed CAP-MR/DD recipients to receive residential supports in settings with greater than six beds. However, the bill was changed this week to legislation to allow certain community colleges to opt out of the federal loan program. As there was no Senate counterpart, the matter will not proceed.

HB 590, Amend Interpreter Laws/Cued Speech (Alexander Sponsor). HB 590 seeks to make clarifying changes regarding cued speech in the laws regulating the practice of interpreters and transliterators. A committee substitute making technical changes received a favorable report from the House Health and Human Services this week, along with a favorable vote from the full House. The bill will next be heard in the Senate Health committee.

HB 595, Reorganization/Legislative Oversight Comns (Barnhart, Burr Sponsors). HB 595 proposes a new structure for the numerous legislative committees and commissions, including establishing a Joint Legislative Oversight Committee on Health and Human Services, which merges the Study Commission on Aging, the Joint Legislative Health Care Oversight Committee, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, and the Public Health Study Commission. The bill, which passed through the House in April, received a favorable report from the Program Evaluation committee, and a favorable vote from the full House this week. Because the Senate did make changes, the bill will now go back to the House for concurrence. It is notable that there was some concern during the discussion that there would no longer be a separate MH/DD/SAS oversight committee, but the merger of the HHS committees remains.

HB 606, Sheriff/Inspect Prescription Drug Records (McElraft, Randleman, McLawhorn Sponsors). HB 606 provides that a sheriff or a designated deputy sheriff who is assigned to investigate the diversion and illegal use of prescription medication or pharmaceutical products and has a reasonable suspicion in a specific investigation may access data in the controlled substance reporting system. A committee substitute received a favorable report from the House Judiciary B committee and passed the full House. It will now proceed to the Senate where it is unclear whether it will be heard before the Senate adjourns.

HJR 612, Incapacity to Proceed/LRC Study (Randleman, Hurley Sponsors). House Joint Resolution 612 seeks to authorize the Legislative Research Commission to study the current criminal and mental health laws and procedures regarding incapacity to proceed to trial and involuntary commitment. It received a favorable report from the House Rules Committee and a favorable vote from the full House this week. It has been referred to the Senate Rules committee.

HB 618, Streamline Oversight/DHHS Service Providers (Lewis and Hurley Sponsors). HB 618 seeks to streamline duplicate oversight of DHHS service providers. A Proposed Committee Substitute, supported by Disability Rights NC, was approved by the House Health and Human Services Committee last month but the bill was not heard by the House Appropriations committee until this week. The full Appropriations committee gave a favorable report to a committee substitute that decreased the number of members on the task force to 18 from 20 by removing 2 provider members. The full House approved the measure after one additional amendment from Representative Bryant adding two consumers to the task force, putting the task force membership back at 20. The bill has now been referred to the Senate Rules committee.

HB 622, Nursing Homes/Food Service Inspections (McCormick, Stevens, Cleveland, Glazier Sponsors), was previously titled “Article 3A Administrative Procedures.” The bill now seeks to allow nursing homes and nursing home beds licensed under Chapter 131E that are also certified by Medicare and Medicaid to be limited to one food service inspection per year unless the facility receives a grade "B" or lower on its annual inspection. It received a favorable report in the House Health and Human Services committee and a favorable vote from the full House last week. It is scheduled to be heard Tuesday in the Senate Health committee.

HB 625, Bill of Rights/Deaf/Hearing Impaired (Blackwell, Farmer-Butterfield Sponsors). HB 625 as originally filed sought to create a Deaf Child’s Bill of Rights that would mandate that an IEP team consider a child’s individual communication needs. A committee substitute that turned the bill into a study that would establish the Study Committee on Establishing a Bill of Rights for Deaf or Hearing Impaired Children was approved by the House Judiciary A committee and referred to House Rules.

HB 646, Prison Hospital Completion (Daughtry Sponsor). The bill allows the Department of Correction to use funds allocated for 2 capital projects that came in under budget to finish the hospital at Central Prison (funds will be used to finish the facility, purchase medical equipment, and expand the kitchen). The prison hospital will have 120 beds and will include beds for inmates with psychiatric needs. The bill received a favorable report from Senate Health Care committee last week and will next be heard by the full Senate.

HB 677, Discharge of Adult Care Home Residents (Lewis). HB 677 seeks to change the law governing Adult Care Home discharge of residents. A committee substitute that Disability Rights NC and other advocacy groups worked on with the industry and the department was approved by the House Health and Human Services committee on Tuesday. The committee substitute no longer places sole responsibility for discharge on the Department of Social Services nor does it provide immunity to an adult care home that attempts to discharge an individual for behaviors if the resident remains at the adult care home. The committee substitute creates an Adult Care Home Discharge team that will facilitate finding an appropriate placement for a discharged resident, and places final decision making authority over discharge with a Division of Medical Assistance Hearing Unit. The bill was further amended by Representative Blackwell on the House floor before receiving approval from the full House – the amendments clarified that until an appeal is resolved or while a decision on appropriate placement is pending of the team, the resident will remain in the placement unless the resident consents to another placement; and that the person designated to receive notice of discharge and the resident’s legal representative will receive notice of discharge. The bill will next be heard in the Senate Health Care committee. The interested parties continue to work to improve the bill.

HB 678, Pilot Release of Inmates to Adult Care Homes (Lewis Sponsor). HB 678 seeks to establish a pilot program to allow certain inmates released from confinement to be placed in an Adult Care Home (only the inmates selected for the pilot will reside in the facility) to receive Personal Care Services and Medication Management. A committee substitute received a favorable report from the House Health and Human Services committee and a favorable vote from the full House last week. The bill will next be heard in the Senate Health Care committee.

HB 736, Amend Law re: School Discipline (Langdon, Luebke, Daughtry, Lucas Sponsors). HB 736 seeks to make a number of changes to Chapter 115C regarding school discipline with the goal of keeping students in school. It is a consensus bill supported by Disability Rights NC that numerous entities representing schools and students contributed to. The bill had previously been considered in the House and the Senate but the House and Senate versions crossed over separately. Thus, one version of the bill needed to proceed through the other chamber before becoming law. HB 736 received a favorable report from the Senate Education committee and the full Senate last week. However, the bill was amended on the Senate floor to incorporate the language regarding corporal punishment that is laid out in SB 498 (which has passed the Senate but has not yet been taken up in the House). Thus, the sponsor of HB 736, Representative Langdon, asked the House not to concur since the House has not voted on the separate Corporal Punishment bill yet (although SB 498 is scheduled to be taken up in the House Education committee on Tuesday morning) . A conference committee has been appointed and the expectation is that the committee will remove the corporal punishment language and report back this week.

HB 808, Revise Laws on Adult Care Homes (Burr). HB 808 seeks to waive annual inspections of Adult Care Homes that achieve the highest rating, and to develop an informal dispute resolution procedure that allows Adult Care Homes to dispute cited inspection deficiencies. A committee substitute was approved by the Senate Health Care committee this week and the bill is scheduled to be considered by the full Senate on Tuesday.

HB 916, Statewide Expansion of 1915(b)/(c) Waiver (Barnhart, Burr, Insko Sponsors). HB 916 seeks to have managed care behavioral health waiver (modeled after PBH) statewide by July 1, 2013, and sets out specific requirements for the expansion of this managed care behavioral health Medicaid waiver. For DRNC’s updated position paper on the 1915 b/c waiver, please click here. The bill was heard over the course of 2 meetings of the Senate Mental Health committee last week, an unusual occurrence to dedicate so much time to one bill during crossover week. On Wednesday, after a great deal of testimony from the sponsors and the Secretary, only a few minutes were left for public comment. After one parent of an adult child with DD spoke, the committee moved to adjourn without a vote as they were out of time. This left other members of the public without the opportunity to speak. Thus, the committee met again on Thursday morning and voted to approve the legislation. The full Senate voted 29-16 to approve the bill later that day. The bill will now be sent to the Governor.

SB 8, No Cap on Number of Charter Schools (Stevens sponsor). This bill eliminates the existing cap of 100 charter schools. This bill has been in conference between the House and Senate for the past 2 months. The conference committee reported in this week. The legislation now simply lifts the cap on charter schools. The compromise agreement removes the current limit of 100 charters and allows existing schools to increase annual enrollment by 20 percent. The conference report scraps some of the more controversial provisions - including one that would have granted broader authority to an independent charter board to approve new schools. The latest version also no longer requires charters to provide transportation or free and reduced lunches to low-income students. The Governor is expected to approve the compromise legislation.

SB 465, Behavioral Health Management (Hartsell Sponsor). SB 465, as originally filed, sought to allow LMEs that are operating under Medicaid Managed Care waivers (i.e., 1915(b) or 1915(b)/(c) combo waivers like PBH) to organize under Chapter 131E of the General Statutes, Article 2 governing Public Hospitals. A committee substitute that changed the bill into a study directing the Program Evaluation Division of the General Assembly to study the impact of Medicaid waivers, LME consolidation, and LME expansion on the current governance model for area authorities, single-county programs, and multicounty programs established under Chapter 122C, was approved by the Senate Mental Health Committee and the full Senate last week. It has been referred to the House Health and Human Services committee.

SB 496, now known as Medicaid and Health Choice Provider Req (was PPACA/Required Fraud and Abuse Provisions) (Pate Sponsor). SB 496 seeks to implement screening for Medicaid and Health Choice providers, identifying providers of certain types of services as low, moderate or high risk. It also provides for criminal history record checks for certain providers. It was approved by the Senate Health committee and the full Senate last week, and the bill has now been referred to the House Health and Human Services committee.

SB707, School Violence Prevention Act (Tucker). SA committee substitute for this bill was approved by the Senate Judiciary II committee this week. While the committee substitute removed many of the provisions of particular concern to Disability Rights NC, we did not oppose the bill moving forward as the bill sponsor expressed a desire to continue to work on the bill. However, the bill was pulled from the Senate floor and re-referred to the Senate Appropriations committee, where it will need to be heard before proceeding to the Senate floor. However, because of the appropriations issue, the bill does not need to meet the crossover deadline.

SB 781, Regulatory Reform Act of 2011 (Rouzer and H. Brown, Sponsors). SB 781 amends Chapter 150B of the NC general statutes to add requirements for agencies in rulemaking, and analysis of the fiscal impact of rules. It also incorporates changes regarding final agency decision-making authority. SB 781 received favorable reports from the Senate Agriculture/ Environment/Natural Resources and Commerce committees, as well as approval from the full Senate last week. It will now proceed to the House.

Bill Update for the Week of May 30

2011-06-06T09:46:00.000-04:00

Both chambers were busy with the state budget last week, which successfully passed both chambers and is now with the Governor. The details of the budget will be detailed in a separate post. The coming week promises to be very busy as we approach the cross-over deadline on Thursday.

The following bills had action this week:

HB 115, North Carolina Health Benefit Exchange Act (Dockham, Brubaker, Wray, Murry Sponsors). HB 115 seeks to establish a Health Benefit Exchange to make available qualified health benefit plans beginning in 2014. This bill creates a version of the exchange that is governed by a board that includes insurers as voting members and is lacking in consumer protections. Last week we reported that HB 115 passed the House. It was referred to the Senate Rules Committee this week, which is a sign that the Senate will not take the bill up this session.

HB 233, Department of Correction/Ex-Offenders (Pierce, Bryant, M. Alexander, Frye Sponsors). This bill was a recommendation of the Joint Select Committee on Ex Offender Reintegration into Society. HB 233 designates the Department of Correction (DOC) Office of Research and Planning (ORP), as the single State agency responsible for the coordination and implementation of ex-offender reentry policy initiatives, including the StreetSafe Task Force, the Justice Reinvestment Initiative of the Council of State Governments (CSG), and the recommendations of the Joint Select Committee on Ex Offender Reintegration into Society. HB 233 successfully passed the full House last week and is now in the Senate where it was referred to the Senate Rules committee.

HB 344, Tax Credits for Children with Disabilities (Stam, Randleman, Jordan and Jones Sponsors). The bill creates an individual income tax credit for families of children with disabilities who require special education and are attending a nonpublic school, including home school. The credit is equal to the amount the taxpayer paid for tuition and special education and related services expenses, not to exceed three thousand dollars ($3,000) per semester. It also creates a Fund for Special Education and Related Services, with $2,000 per tax credit given being transferred to the Fund each year. A committee substitute for HB 344 received a favorable report from the House Finance committee last week. It has now been referred to House Appropriations.

HB 374, Eugenics Records/Public Records Exemption (Womble and Parmon Sponsors). The bill makes clear that records in the custody of the State concerning the North Carolina Eugenics Board program are not public records to the extent they concern: (i) persons impacted by the program, (ii) persons or their guardians or authorized agents inquiring about the impact of the program on them, (iii) persons or their guardians or authorized agents inquiring about the potential impact of the program on others. It also states that a person impacted by the program may obtain that person's individual records under the program, and a guardian or authorized agent of that person may also obtain them. HB 374 received a favorable report from House Judiciary A this week and successfully passed the full House. It will next be referred to a Senate committee.

HB 417, Extend Time for Site of Low/Moderate Income Housing (McGrady Sponsor). HB 417 seeks to extend the time, for tax purposes, that real property may be held by a non-profit organization as a future site for housing for individuals or families with low or moderate incomes from 5 to 10 years. HB 417 successfully passed the full House this week and will now proceed to the Senate.

HB 474, Protect Adult Care Home Residents (Weiss, Hollo, Farmer-Butterfield, Earle Sponsors). HB 474 proposes changes to Chapter 131D governing adult care homes to increase minimum continuing education, training, competency evaluation and inspection requirements for Adult Care Home medication aides, related to Infection Control Requirements. HB 474 was signed into law this week, and is now Chaptered Session Law 2011 99.

HB 542, Tort Reform for Citizens and Businesses (Rhyne, McComas, Brisson and Crawford Sponsors). HB 542 seeks to make several changes to the NC General Statutes regarding tort cases but most significantly seeks to protect the makers of any drug approved by the FDA. As filed the bill had many other aspects to it, which are now being addressed in other legislation. HB 542 passed the House this week and will now proceed to the Senate.

HB 622, Nursing Homes/Food Service Inspections (McCormick, Stevens, Cleveland, Glazier Sponsors), was previously titled “Article 3A Administrative Procedures.” The bill now seeks to allow nursing homes and nursing home beds licensed under Chapter 131E that are also certified by Medicare and Medicaid to be limited to one food service inspection per year unless the facility receives a grade "B" or lower on its annual inspection. It is scheduled to be heard in the House Health and Human Services committee Tuesday.

HB 641, Certificate of Relief Act (Guice, Floyd Sponsors). HB 641 seeks to establish a Certificate of Relief under state law that will allow certain individuals convicted of a crime to seek relief from “collateral consequences,” of the conviction. It successfully passed the House this week and will next be heard in the Senate.

HB 656, Photo ID for Certain Controlled Substances (Guice, Ingle, Faircloth Sponsors). HB 656 seeks to direct pharmacies to require photo identification prior to dispensing Schedule II Controlled Substances. Schedule II includes a number of drugs for pain relief, as well as any drug that contains amphetamine (like Adderall). HB 656 passed the full House this week and will next be heard in the Senate.

HB 659, Capital Procedure/Severe Mental Disability (Stevens, Glazier, McGrady, Harrison Sponsors). This is a Disability Rights NC agenda bill. It seeks to amend the capital trial, sentencing and postconviction procedures for a person with a severe mental disability to address the issue upfront in trial, and to remove the death penalty as the highest punishment if the individuals qualifies as a person with severe mental disability under the law. It also seeks to provide that Not Guilty by Reason of Insanity is not an available defense if prior alcohol or drug use are the sole cause of the psychosis. HB 659 received a favorable report from the House Appropriations committee last week. It was then heard on the House floor on Thursday, where the bill was amended in an attempt to placate the district attorneys, who are now very opposed to the bill. Because of the sudden concern about opposition from the district attorneys, the bill was postponed until Friday. On Friday evening, the House again took up the bill. Representative Tim Moore moved to amend the bill to remove the post-conviction section. After some discussion with other representatives pointing out how such an amendment would weaken the bill, Moore withdrew his amendment but objected to 3d reading to temporarily displace the bill. Finally, the full House voted 84-31 with strong bipartisan support in favor of the bill. To see who voted for and against click here.

HB 709, Protect and Put NC Back to Work (Folwell, Dollar, Hager, Crawford Sponsors). HB 709 seeks to reform the Workers’ Compensation Act. It passed the full House this week and has been referred to the Senate Insurance committee.

HB 855, Personal Learning Plan for Each Child (Brandon). HB 855, as originally filed, sought to require public schools to provide a Personal Education Plan for every student. However, the version that proceeded through the House last week adds a new section to Chapter 115C of the state statutes to create personal learning plans, which are self-assessments, for students in grade 6 through high school who do not have an IEP or a PEP. It successfully passed the House and has been referred to the Senate Education committee.

HB 887, Zoning/ Temp. Family Health Care Structures (Moffitt, Howard, Setzer sponsors). This bill requires cities to allow Temporary Family Health Care Structures, which are transportable residential structures, providing an environment facilitating a caregiver's provision of care for a mentally or physically impaired person, that (i) is primarily assembled at a location other than its site of installation, (ii) is limited to one occupant who shall be the mentally or physically impaired person, (iii) has no more than 300 gross square feet, and (iv) complies with applicable provisions of the State Building Code and G.S. 143 139.1(b). A committee substitute developed in a subcommittee was approved by the House Government Committee this week. The bill will next be heard in House Finance.

HB 916, Statewide Expansion of 1915(b)/(c) Waiver (Barnhart, Burr, Insko Sponsors). HB 916 seeks to have the waiver statewide by July 1, 2013, and sets out specific requirements for the expansion of this managed care behavioral health Medicaid waiver. For DRNC’s updated position paper on the 1915 b/c waiver, please click here. Despite numerous consumers and family members speaking against, and many concerns raised by the committee members, a committee substitute was heard and voted on favorably in the House Health and Human Services committee last week. The committee substitute added two functions that the managed care entities may subcontract: treatment plan development and referral services. This addition was a concession to the Arc of NC, who officially dropped his opposition to the bill, although it does not support the bill. The bill was then passed by the full House in a 92-24 vote on Wednesday. The bill was amended to add stakeholder input as a requirement for the Department in developing the strategic plan that will be submitted to the appropriate Oversight Committee of the General Assembly. It will now be referred to the Senate.

SB 578, Facilitate Transfer SPH Beds Com. Facility (Hartsell) was formerly titled “LME Minimum Population.” SB 578 now weeks to allow the Secretary of DHHS to transfer beds from a State psychiatric hospital to a community facility pursuant to the State Medical Facilities Plan Policy PSY 1 without a written memorandum of agreement between the local management entity serving the county where the beds are to be located and the facility submitting the proposal if certain conditions are met, including that the facility submits a CON application, the facility commits to serve the type of short term patients normally placed at the State psychiatric hospital, the facility proposing to operate the beds is a provider created under G.S. 131E 17 and the facility proposing to operate the beds is in a single county area authority. The bill is intended to fix an issue in the Mecklenburg catchment area that has prevented the transfer of beds from Broughton to the Carolinas Medical Center (the beds at Broughton are un-staffed so this will not decrease, but rather increase, available beds). It received a favorable report from the Senate Mental Health committee and will be voted upon in the full Senate next week.

Bill Update for the Week of May 23

2011-05-27T13:44:00.000-04:00

Legislation With Activity This Week:

HB 115, North Carolina Health Benefit Exchange Act (Dockham, Brubaker, Wray, Murry Sponsors). HB 115 seeks to establish a Health Benefit Exchange to make available qualified health benefit plans beginning in 2014. This bill creates a version of the exchange that is governed by a board that includes insurers as voting members and is lacking in consumer protections. HB 115 passed the House this week with bipartisan support in an 83-34 vote. An amendment added to the bill adds language regarding the necessity of a conflict of interest policy but still allows current insurance company employees to serve on the board. The bill will now be referred to a Senate committee.

HB 188, Taxpayer Bill of Rights (Blust, Killian, Holloway, Dollar Sponsors). The bill seeks a constitutional amendment that would limit state spending to population growth plus inflation. Even though health care and other costs are increasing much faster than the overall inflation rate, the state could not adjust its spending to keep pace, which would result in massive cuts to healthcare and support services. HB 188 was heard but not voted on in the Judiciary A committee this week. The Treasurer’s office spoke against the bill, along with the Justice Center, but broad public comment in opposition was not allowed.

HB 233, Department of Correction/Ex-Offenders (Pierce, Bryant, M. Alexander, Frye Sponsors). This bill was a recommendation of the Joint Select Committee on Ex Offender Reintegration into Society. HB 233 designates the Department of Correction (DOC), Office of Research and Planning (ORP), as the single State agency responsible for the coordination and implementation of ex-offender reentry policy initiatives, including the StreetSafe Task Force, the Justice Reinvestment Initiative of the Council of State Governments (CSG), and the recommendations of the Joint Select Committee on Ex Offender Reintegration into Society. HB 233 received a favorable report from the House Government committee this week. It will next be voted upon by the full House.

HB 474, Protect Adult Care Home Residents (Weiss, Hollo, Farmer-Butterfield, Earle Sponsors). HB 474 proposes changes to Chapter 131D governing adult care homes to increase minimum continuing education, training, competency evaluation and inspection requirements for Adult Care Home medication aides, related to Infection Control Requirements. The House concurred in the Senate committee substitute this week and it now proceeds to the Governor for her signature.

HB 618, Streamline Oversight/DHHS Service Providers (Lewis and Hurley Sponsors). HB 618 seeks to streamline duplicate oversight of DHHS service providers through recommendations of a task force that would include Disability Rights NC. The bill was scheduled for a vote in the full House this week but was withdrawn from the calendar and re-referred to the House Appropriations committee.

HB 623, Eliminate Agency Final Decision Authority (McCormick, Stevens, Cleveland, Glazier Sponsors). HB 623 would remove final decision making authority from agencies in contested cases under Chapter 150B, including Medicaid appeals. HB 623 passed the full House this week after 2 amendments were made on the floor. One amendment addressed Article 3A hearing procedures (which governs “other” administrative hearings regarding agencies like the department of insurance, the building code council and the banking commission). The second amendment added language to the bill directing DHHS to seek a waiver from the single state agency requirements, which will ensure that the Medicaid appeals process continues to comply with federal law and CMS requirements.

HB 656, Photo ID for Certain Controlled Substances (Guice, Ingle, Faircloth Sponsors). HB 656 seeks to direct pharmacies to require photo identification prior to dispensing Schedule II Controlled Substances. Schedule II includes a number of drugs for pain relief, as well as any drug that contains amphetamine (like Adderall). A committee substitute received a favorable report from the House Judiciary B committee this week.

HB 823, Governance of the Dep’t of Public Instruction (Holloway, Hilton, Brubaker, Blackwell Sponsors). The legislation proposes a constitutional amendment that voters would decide in 2012. It would make the state superintendent of schools a voting member of the State Board of Education and give the House and Senate appointments to the board, among other changes. The bill, approved in a 106-10 vote, now heads to the Senate.

SB 316, Additional Section 1915 Medicaid Waiver Sites (Hartsell Sponsor). SB 316 authorizes DHHS to allow additional 1915 (b)/(c) Medicaid waiver sites and to allow third-party billing for state facilities. This would allow further expansion of 1915(b)/(c) waivers beyond PBH, Mecklenburg and Western Highlands, without legislative approval. The Senate concurred with the House amendment this week and the bill now proceeds to the Governor.

SB 512, Adult Day Care/Overnight Respite Program (Clary). SB 512 directs the Department of Health and Human Services to conduct a pilot program to assess the provision of overnight respite services in adult day care programs. The bill received a favorable report from the House Health and Human Services committee this week, as well as approval from the full House, and ratification by the Senate. It now proceeds to the Governor for her signature.

Coming Up Next Week:

HB 916, Statewide Expansion of 1915(b)/(c) Waiver (Barnhart, Burr, Insko Sponsors). HB 916 is scheduled to be heard in the House Health and Human Services committee on Tuesday at 10 am. HB 916 seeks to have the waiver statewide by July 1, 2013, and sets out specific requirements for the expansion of this managed care behavioral health Medicaid waiver: accountability for the development of a local system that ensures easy access to care, availability and delivery of necessary services, and continuity of care; fidelity to the PBH model; designate entities to manage the waiver through either merged LMEs or through interlocal agreement among LMEs; use of managed care strategies to reduce escalating costs in Medicaid while ensuring medically necessary care and deploy a system for the allocation of resources based on reliable assessment of intensity of need; phase out the CAP-MR/DD waiver; and design the Innovations waiver to serve the maximum number of individuals with intellectual and developmental disabilities within aggregate funding. It also specifies that county governments will not be financially liable for overspending or cost overruns associated with the operation of the waiver (i.e., the risk doesn’t shift). HB 916 specifies a number of conforming statute changes regarding the size of LMEs. Section 4 also exempts the Department from rulemaking in implementing, operating, or overseeing new Medicaid waiver programs or amendments to existing Medicaid waiver programs. For DRNC’s updated position paper on the 1915 b/c waiver, please click here.

BTC Proposes Reform to North Carolina’s Tax and Revenue System

2011-05-27T13:32:00.002-04:00

by Holly Safi

People with disabilities in North Carolina are facing drastic cuts in funding to important services, $2 Billion from Medicaid alone. North Carolina’s 2012 revenue is expected to be $2.4 billion less than it needs to maintain the current level of expenditures. Under the existing tax structure the poorest North Carolinians pay a significantly greater percentage of their income to state and local taxes than do the wealthiest. Simply cutting funding, as proposed in the recent House and Senate budgets, is a short-term solution that will harm those with the greatest needs now and the NC economy in the long run.

The North Carolina Budget & Tax Center (BTC), a project of the North Carolina Justice Center, has developed a progressive plan to reform the NC system of revenue and taxation to ensure it will be equitable among its citizens and businesses, adequate to fund necessary public structures and investments, and stable enough to survive downswings of the economy. The BTC estimates that this plan could raise $1.3 billion in revenue over the next fiscal year. Some highlights of this plan are as follows:

Personal Income Tax Reform (anticipated benefit of $634 million)
• Increase the number of income tax brackets from three with rates of 6.00%, 7.00%, and 7.75% to six with rates ranging from 5.00% at the lowest bracket to 8.50% for the top bracket.
• Calculate taxable income based on adjusted gross income instead of federal taxable income which includes various deductions.
• Significantly increase the standard deduction but eliminate other deductions and credits except mortgage interest, medical expenses, and charitable contribution itemized deductions.
• Allow a 3% credit of either the standard deduction or the total of the three allowed itemized deductions to give a standard tax benefit to all income levels.
• Double the state Earned Income Tax Credit and merge the child tax credit and personal exemption into a $180 per-person credit so that tax benefits increase with family size, not income.

Sales Tax Reform (anticipated benefit of $500 million)
• Current sales tax that taxes primarily goods falls heaviest on the poor who tend to buy goods rather than depend on services.
• Decrease the state sales tax from 4.75% to 3.75%
• Expand the state sales tax to incorporate most consumer services.

Business Tax Reform (anticipated benefit of $202 million)
• Require multi-state corporations to file one single tax return rather than shifting their profits to states with lower taxes.
• Stop preferential treatment of LLCs and tax them the same as other corporations.
• Eliminate other “privilege” taxes that have shown ineffective in job creation.

Tax Expenditure Reform (anticipated benefit difficult to measure)
• Tax expenditures are funds that are “spent” by not collecting them in the first place: credits, deductions, exemptions, etc. They often do not get continued review of necessity and/or effectiveness once they are enacted.
• Give tax expenditures the same rigorous scrutiny as appropriations during each budget cycle.

Read the report for yourself here.

Senator Burr Co-sponsors Medicaid Improvement and State Empowerment Act

2011-05-23T14:02:00.000-04:00

Another proposal to reform Medicaid from our own Senator Richard Burr. The text of the bill is not yet available but will be posted online within the next few days. The press release regarding the legislation is below.

May 19, 2011 Thursday
PRESS RELEASE
SENATORS BURR, COBURN INTRODUCE BILL TO REFORM AND STRENGTHEN MEDICAID
Contact: David Ward (Burr) (202) 228-1616

WASHINGTON, D.C. - Today, U.S. Senators Richard Burr (R-North Carolina), Tom Coburn (R-Oklahoma), and Saxby Chambliss (R- Georgia) introduced the Medicaid Improvement and State Empowerment Act, a bill that will reform the Medicaid program to improve care for patients and empower states with the flexibility and financial predictability that they need to strengthen their programs.

"This bill is an important first step in reforming our nation's health care system and fixing our broken entitlement programs," Senator Burr said. "States have a proven track record of being able to adopt innovative solutions to improve patient care. By giving them more control over their own Medicaid programs, we are allowing states to innovate and better meet their needs and, most importantly, the health care needs of their patients."
"If entitlement programs like Medicare, Medicaid and Social Security are not reformed they won't be able to provide promised benefits. It is that simple. Seniors and low-income Americans need Washington to produce solutions, not attack ads. Our broken Medicaid program shows that access to a government health care program does not guarantee access to health care. Our bill will help fix a program that denies patients' access to 40 percent of doctors," Dr. Coburn said. "The path to fiscal sustainability begins with the reform of our nation's entitlement programs," said Senator Chambliss. "The Medicaid Improvement and State Empowerment Act will give states such as Georgia the flexibility to design programs specifically tailored to support our most vulnerable beneficiaries and allow them the control to effectively plan for future budgets decisions."
Currently, Medicaid, a program rife with issues of waste and abuse, promises coverage to patients, but this promise does not result in access - 40% of physicians deny access to patients in this program. Additionally, states do not have the needed flexibility to make basic improvements to their programs, and are often forced to make drastic cuts to provider reimbursements, which further limit patients' access to care.
The Medicaid Improvement and State Empowerment Act frees states from bureaucratic red tape and empowers them to immediately make reforms that will improve care for patients. It repeals the new health care law and the maintenance of effort requirement contained in the stimulus, and transitions from the current FMAP model to a health grants model that provides medical assistance for low-income Americans and long-term care services and supports for low-income elderly and disabled individuals. The bill maintains the current FMAP model for acute care for dual eligible and disabled individuals; however, states are given the flexibility to enroll these patients into managed care.

Bill Update for the Week of May 16

2011-05-22T11:14:00.000-04:00

HB 115, North Carolina Health Benefit Exchange Act (Dockham, Brubaker, Wray, Murry Sponsors). HB 115 seeks to establish a Health Benefit Exchange to make available qualified health benefit plans beginning in 2014. This bill creates a version of the exchange that is governed by a board that includes insurers as voting members and is lacking in consumer protections. HB 115 was scheduled to be voted on in the full House last week but was postponed until May 25. Given the opposition to the bill from both ends of the political spectrum - consumer advocates, including Disability Rights NC, and the John Locke Foundation at the other end, members may be re-thinking their support of their Insurance industry-backed bill. Click here for an article on the status in the News & Observer.

HB 474, Protect Adult Care Home Residents (Weiss, Hollo, Farmer-Butterfield, Earle Sponsors). HB 474 proposes changes to Chapter 131D governing adult care homes to increase minimum continuing education, training, competency evaluation and inspection requirements for Adult Care Home medication aides, related to Infection Control Requirements. The bill passed the full Senate last week, and is now back in the House for concurrence.

HB 493, Landlord Tenant Law Changes (Howard, Blust, Randleman Sponsors). HB 493 as originally filed sought to greatly weaken certain rights & protections of tenants. However, the bill has been modified to make clear that If the tenant fails to make rental payments during an appeal, as provided in the undertaking within five days of the day rent is due under the terms of the residential rental agreement, the clerk of superior court shall, upon application of the landlord, immediately issue a writ of possession, and the sheriff shall dispossess the tenant; raises the value of personal property that may be donated or disposed of after a tenant abandons or has been ejected; modifies the permitted uses of the deposit; and makes small changes to the laws on vacation rentals regarding cleaning fees. You may remember from last week’s post that the bill was postponed in the House while members sought an ethics opinion on whether any member who is a landlord has a conflict of interest with respect to the bill. After assurances on the issue, the bill passed the House unanimously. It has now been referred to the Senate Judiciary II committee.

HB 618, Streamline Oversight/DHHS Service Providers (Lewis and Hurley Sponsors). HB 618 seeks to streamline duplicate oversight of DHHS service providers. A Proposed Committee Substitute, supported by Disability Rights NC, was approved by the House Health and Human Services Committee last week, and is scheduled to be heard by the full House this week. The new version sets up a task force that includes advocates, consumers, providers, and legislators to make recommendations to align oversight of DHHS providers. There was an amendment in the committee to add 2 additional members to the Task Force - one who is a member of the NC Providers Council, and one member of the NC Psychiatric Assn. Some concerns have been raised that this now shifts the balance of membership on the committee toward providers, and away from advocates. The Senate version, SB 525, passed the full Senate last week and has been referred to the House Appropriations committee.

HB 623, Eliminate Agency Final Decision Authority (McCormick, Stevens, Cleveland, Glazier Sponsors). HB 623 would remove final decision making authority from agencies in contested cases under Chapter 150B, including Medicaid appeals. The legislation would affect all agencies - everything from personnel to permit disputes. The bill was schedule to be voted on in the full House last week but was postponed to allow the sponsors additional time to work with those parties who have concerns about the bill. It is scheduled to be heard tomorrow night in the House.

HB 658, Change Early Voting Period (Jones, Stam, Colins, Sager Sponsors). HB 658 seeks to shorten the early voting period by a week (by delaying the start of early voting from the third Thursday before an election to the second Thursday). The bill passed the House on 3d reading last week by a 60-58 vote, after adopting an amendment offered by Rep. Jones that would keep early voting sites open later, allowing people who get off work at 5 p.m. more time to vote. Six Republicans (Guice, Faircloth, Jordan, Lewis, McGrady and Torbett) joined 52 Democrats in voting against the bill. The bill now goes to the Senate.

SB 316, Additional Section 1915 Medicaid Waiver Sites (Hartsell Sponsor). SB 316 authorizes DHHS to allow additional 1915 (b)/(c) Medicaid waiver sites and to allow third-party billing for state facilities. This would allow further expansion of 1915(b)/(c) waivers beyond PBH, Mecklenburg and Western Highlands, without legislative approval. SB 316 received a favorable report from the House Health and Human Services committee this week, where Sponsor Senator Hartsell referred to this bill as the "Free PBH" bill because the bill's main purpose is to allow PBH to expand its geographic coverage area. The bill was then voted upon favorably by the full House, where an amendment was passed to add the language directing the department to consult with stakeholders before approving additional sites. 15 members voted against the bill on 2d reading (Alexander, K.; Bell; Brandon; Bryant; Cotham; Earle; Floyd; Graham; Hall; Hamilton; Harrison; Jackson; Mobley; Parmon; Weiss) and on 3d (Alexander, K.; Bell; Brandon; Cotham; Earle; Graham; Hall; Hamilton; Harrison; Jackson; McGuirt; Mobley; Moore, R.; Parmon; Weiss). The bill will now proceed back to the Senate for concurrence.

SB 384, Conforming Changes/Persons with Disabilities Act (Hartsell). This is a Disability Rights NC agenda bill. It seeks to amend the North Carolina Persons with Disabilities Protection Act to conform to the Americans with Disabilities Amendments Act of 2008. The bill received a unanimous favorable report in the House last week and is now awaiting the Governor’s signature.

SB 512, Adult Day Care/Overnight Respite Program (Clary). SB 512 directs the Department of Health and Human Services to conduct a pilot program to assess the provision of overnight respite services in adult day care programs. The bill passed the full Senate last week and has now been referred to the House Health and Human Services committee.

SB 595, Voter Identification At Polls (Clary). SB 595 is the Senate version of the Voter ID bill (which is different from the House Voter ID bill, HB 351, which is awaiting a hearing in the House Appropriation committee). SB 595 would require voters to produce valid photo identification in order to vote. It would also require county boards of elections to make voter identification cards including a photo and other personal information available, without a fee, to any voter who does not have a valid driver’s license or state identification card. This bill would allow for voters without the required identification to vote a provisional ballot. The bill would also waive the fee for Special Identification Cards produced by the DMV for those who are blind, over age 70, homeless, or lack other valid photo identification but are registered to vote. The bill was discussed on Tuesday in the Senate Judiciary I committee. There was no public comment and no vote. Senator Tillman suggested the addition of a Medicaid card as a form of ID. There has been a fiscal memo of $3.1 mil but it doesn't include education costs. There has been speculation that the Senate scheduled this hearing in order to prompt the House to move on its version of Voter ID.

Proposals for Medicaid, Medicare, and Social Security Changes

2011-05-20T16:18:00.004-04:00

by Holly Safi
Recently the national debt has received bipartisan attention in Washington. The current federal debt is rising faster than revenue such that, by 2025, revenue may be exhausted each year just to pay interest on debt and to fund Medicare, Medicaid, and Social Security. Two proposals have emerged. Here are some highlights of how each plan would affect some of the programs people with disabilities rely on most:

The House Commission on the Budget “Ryan” Plan, expected savings of $6.2 trillion:
• Medicaid changes to a “block grant” program where each state will receive a set amount of funding based on population growth and inflation. Beginning in 2022, Medicaid will no longer provide acute care for the elderly.
• Medicare changes to a “premium support model” where those eligible would shop a federally-managed exchange of private insurance plans and the government would provide a set grant to the insurer to assist the beneficiary in paying the premium for the plan. In addition, the eligible age for Medicare will increase to 67 by 2033.
• SNAP, SSI, unemployment would be part of a larger group of services that will have funding cut in half by 2021.
• Repeal some provisions of the Affordable Care Act (ACA), including the Medicaid extension and the CLASS Act.
• Increase the Dept. of Defense budget to $692.5 billion ($680 billion in 2010).
• Does not fundamentally change Social Security.

The National Commission on Fiscal Responsibility and Reform Plan , expected savings of $4 trillion:
• Establish a long-term budget for total federal health-care spending, limited to the GDP growth plus 1% each year.
• Place dual eligibles (Medicaid/Medicare) in a Medicaid managed care plan and extend the Medicaid drug rebate to them.
• Establish a single combined annual deductable for Medicare Plan A & B, while restricting Medicare supplemental insurance.
• Keep most of the ACA, except to repeal or reform the CLASS Act
• Lift the cap on taxable income for Social Security and increase the Normal Retirement Age to 68 by 2050, 69 by 2075.
• Repeal the Bush Administration’s tax cuts and reduce the Dept. of Defense budget $400 billion by 2023.
• Does not fundamentally change SNAP, SSI, unemployment.

The Fiscal Commission plan reduces spending in some areas but increases spending in others. The Ryan plan drastically reduces spending, but the Medicaid program that currently provides 60 million Americans with medical care, long-term care, and in-home care for people with disabilities will be cut by $1.4 trillion dollars over 10 years. In North Carolina alone, this could affect 514,000 seniors and people with disabilities on Medicaid, 112,000 direct care workers, and 1.7 million informal caregivers. In addition, Medicare that provides coverage for 47 million seniors and people with disabilities will be cut by $30 billion over a 10 year period. Families USA estimates that 45.6 million children and 7.6 million seniors would lose crucial health care under the Ryan plan.

Read more about the plans at the following links:
The Ryan Plan
The National Commission's Plan
Families USA Special Report
Families USA Special State Report on North Carolina

Bill Update for the Week of May 9

2011-05-16T13:00:00.000-04:00

Updates on Bills with Activity Last Week:

HB 115, North Carolina Health Benefit Exchange Act (Dockham, Brubaker, Wray, Murry Sponsors). HB 115 seeks to establish a Health Benefit Exchange to make available qualified health benefit plans beginning in 2014. This bill creates a version of the exchange that is governed by a board that includes insurers as voting members and is lacking in consumer protections. For more information from AAPD about state health benefit exchanges, see post here. After several weeks in House Insurance, this bill moved through two House committees last week, receiving favorable reports from the House Insurance and Appropriations committees. Despite numerous concerns raised, the bill passed both committees with bipartisan votes. The bill will be heard in the full House this week.

HB 423, Enact First Evaluation Program (Hurley Sponsor); SB 437 (Hartsell Sponsor). HB 423 seeks to codify a piloted practice that allows the Secretary to waive the requirements for a physician or eligible psychologist to perform the initial examination for involuntary commitment and substitute a licensed clinical social worker, a master's level psychiatric nurse, or a master's level certified clinical addictions specialist at the request of an LME. A Proposed Committee Substitute was considered and approved by the House HHS subcommittee on Mental Health last week. New language was added to require reports on involuntary commitments from non-state facilities. The bill passed the full House last week and has been referred to the Senate Rules Committee. The Senate version of the bill passed the full Senate and was referred to the House Judiciary A committee. In order to become law, one version of the bill will need to be heard again in the other chamber.

HB 474, Protect Adult Care Home Residents (Weiss, Hollo, Farmer-Butterfield, Earle Sponsors). HB 474 proposes changes to Chapter 131D governing adult care homes to increase minimum continuing education, training, competency evaluation and inspection requirements for Adult Care Home medication aides, related to Infection Control Requirements. A committee substitute received a favorable report from the Senate Health committee last week and is scheduled to be heard in the full Senate today. After Senate approval, the bill will be sent to the Governor to be signed into law.

HB 493, Landlord Tenant Law Changes (Howard, Blust, Randleman Sponsors). HB 493 as originally filed sought to greatly weaken certain rights and protections of tenants. Due to a great deal of opposition, the bill has been modified to make clear that If the tenant fails to make rental payments during an appeal, as provided in the undertaking within five days of the day rent is due under the terms of the residential rental agreement, the clerk of superior court shall, upon application of the landlord, immediately issue a writ of possession, and the sheriff shall dispossess the tenant; raises the value of personal property that may be donated or disposed of after a tenant abandons or has been ejected; modifies the permitted uses of the deposit; and makes small changes to the laws on vacation rentals regarding cleaning fees. This committee substitute received a favorable vote from the House Judiciary A committee the week of 5/2 and was set to be heard in the full House last week but was postponed when a large number of House members announced that they have a conflict of interest on the bill as landlords. The bill was postponed until this week to address whether there was an actual conflict of interest.

SB 525, Streamline Oversight/DHHS Service Providers (Tucker, Hartsell sponsors) (HB 618 was also filed). SB 525 seeks to streamline duplicate oversight of DHHS service providers. A Proposed Committee Substitute, supported by Disability Rights NC, was approved by the Senate Mental Health Committee last week, and the bill is scheduled to be heard in the full Senate this week. The new version sets up a task force that includes advocates, consumers, providers, and legislators to make recommendations to align oversight of DHHS providers. There is also a budget provision that presents a much less specific plan for this process, and a House version of the bill that is scheduled to be heard in the House Health and Human Services committee this week. Hopefully all of these will be reconciled as we move forward.

HB 623, Eliminate Agency Final Decision Authority (McCormick, Stevens, Cleveland, Glazier Sponsors). HB 623 would remove final decision making authority from agencies in contested cases under Chapter 150B, including Medicaid appeals. It received a favorable report from the House Judiciary A committee last week despite contentions by a lawyer from the Attorney General's office representing DHHS that the change could run afoul of federal Medicaid rules when it comes to disputes over benefits eligibility for that program. The legislation would affect all agencies - everything from personnel to permit disputes. The bill will likely be heard in the full House this week.

HB 658, Change Early Voting Period (Jones, Stam, Colins, Sager Sponsors). HB 658 seeks to shorten the early voting period by a week (by delaying the start of early voting from the third Thursday before an election to the second Thursday). The bill received a favorable report from the House Elections committee in a 16-14 vote last week and passed 2d reading in the full House in a largely partisan vote, 61-53, with 3 Republicans (Faircloth, McGrady and Murry) joining Democrats in voting No. 3d reading is scheduled for tonight in the House.

SB 384, Conforming Changes/Persons with Disabilities Act (Hartsell). This is a Disability Rights NC agenda bill. It seeks to amend the North Carolina Persons with Disabilities Protection Act to conform to the Americans with Disabilities Amendments Act of 2008. The bill received a favorable report in the House Judiciary A committee last week, and will next be voted on in the full House.

SB 498 Modify Law re: Corporal Punishment (Pate, Purcell Sponsors). SB 498 seeks to amend the law related to corporal punishment of children in public schools to allow parents of all students to opt out of a school’s corporal punishment policy. The bill received a unanimous favorable report in the Senate last week and has now been referred to the House Education committee.

SB 512, Adult Day Care/Overnight Respite Program (Clary). SB 512 seeks to allow adult day care programs to provide overnight respite. A proposed committee substitute was approved by the Senate Health Care committee last week and the bill is scheduled to be voted upon in the full Senate this week. The committee substitute now directs the Department of Health and Human Services to conduct a pilot program to assess the provision of overnight respite services in adult day care programs. The bill is set to be heard in the full Senate this week.

SB 648, Amend Law Re: School Discipline (Preston; Tillman; Hartsell). SB 648 seeks to make a number of changes to Chapter 115C regarding school discipline with the goal of keeping students in school. It is a consensus bill supported by Disability Rights NC that numerous entities representing schools and students contributed to. It passed the full Senate in a unanimous vote last week and will next be heard in the Senate. The House version, HB 736, has already passed the full House and has been referred to the House Education committee. One version will have to be heard in the other chamber before the bill can go to the Governor to be signed into law. Press coverage of the vote last week stated that the National Center for Education Statistics says North Carolina ranks third nationally in the rate of short-term school suspensions of between one and 10 days out of school behind South Carolina and Delaware.

SB 669, Dix Property Mental Health Trust Fund (Atwater) SB 669 seeks to require that proceeds from any sale of the Dorothea Dix Hospital Property be placed in the State’s Trust Fund for Mental Health to be used for people with mental illness. The bill was approved by the full Senate last week and will next be heard in the House Finance committee.

House Subcommittee Hears Presentations on ER Waits and Three-Way Contracts

2011-05-12T14:08:00.000-04:00

guest post by Holly Safi

On Tuesday, staff from four NC hospitals presented the House HHS Subcommittee on Mental Health with information regarding services to patients with mental health care needs, particularly long waits in emergency departments (EDs) and the three-way bed contracts the state operates to expand access to inpatient mental health care. A Randolph Hospital official indicated that facility does not have internal capacity for psychiatric care so must hold patients in the ED until transfer is available to an appropriate mental health facility for a psychiatric evaluation. Other hospitals, including the Moses Cone Health System, have psychiatric services but are not equipped to handle some violent patients, and again must hold those patients in their EDs until transfer may be arranged.

A few highlights from their comments:
• One hospital reports the local LME’s crisis team does not respond to emergencies beyond the Monday-Friday work day and encourages consumers with mental health crises to go to EDs on evenings and weekends.
• The same hospital indicated that if a patient has a LME contracted psychiatrist, that psychiatrist ceases service to the patient while in the ED, so psychiatric assessment and treatment is not available until transfer.
• According to the presenters, patients in need of a bed at a state psychiatric hospital wait, on average, 5 days. Some wait as much as 18 days in an ED.
• Long waits contribute to some patients leaving without being seen (approximately 2%).
• Presenters reported this results in disruption of the ED, strains on the hospital staff and security, strains on the resources of local law enforcement, and a safety risk for others in the ED.

Two presenters, one from Pitt County Memorial Hospital and the other from Forsyth Medical Center, discussed the program of three-way beds. The presenters shared the following:
• Goals of the program:
- Increase capacity for inpatients with mental illness.
- Treat patients within their own communities.
- Reduce unnecessary admissions to state hospitals.
- Shorten emergency room waits.
- Facilitate placement of higher needs patients from EDs by giving them priority in transfers to state facilities.
• The three-way bed contracts are contracts between a local hospital, DHHS, and the LME assigned to the area to purchase an expansion of capacity for inpatient psychiatric patients.
• Hospitals are paid a rate of $750 per day per bed by the state. This rate is inclusive of all medical care the patient receives, providing predictable costs for the state but shifting risk to hospitals.
• Many three-way bed patients have medical needs in addition to their mental health needs.
• Robust community supports are necessary to minimize hospitalization.
• Specialty beds for children and adolescents or other patients with special needs are scarce.
• Providers suggested that tiered rates for different levels of care might make the program workable for more providers.

Mike Watson, Deputy Secretary for DHHS, also spoke. Some highlights:
• The State recognizes that wait times in EDs are unacceptable, and much of it is due to lost funding over the last few years which caused hospitals to reduce the number of beds available.
• The State is working to develop additional three-way contracts and increase the number of three-way beds available.
• The 1915 b/c waiver would create incentives for LMEs to keep people out of EDs by requiring them to pay for ED services.

In a March 1, 2011 study by the NC Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the state gathered information regarding admissions and wait times for the month of November 2010 from 68% of EDs located throughout the state. Some information from that study:
• More than 3% of all admissions to the reporting EDs presented primary behavioral health crises (MH/DD/SA) with a total average ED wait time of 9 hours 38 minutes.
• Of those, 51.1% of behavioral health admissions were discharged home with an average ED wait time of 6 hours 38 minutes.
• 24.3% of behavioral health admissions resulted in psychiatric hospitalization.
- 21.7% were admitted to community psychiatric hospitals with an average ED stay of 14 hours 11 minutes
- 2.7% were admitted to state psychiatric hospitals with an average ED stay of 26 hours 38 minutes

Bill Update for the Week of May 2

2011-05-06T14:05:00.000-04:00

New Bills Filed This Week:

HB 894, Borderbelt AIDS Resources Team Funds (Pierce, Graham sponsors). HB 894 seeks to appropriate $50,000 to the Borderbelt AIDS Resources Team (BART), a nonprofit organization, to enable the organization to continue to provide community based HIV/AIDS services to people living in Robeson County and surrounding areas. It was introduced in the House this week and has been referred to the House Rules committee.

HB 916, Statewide Expansion of 1915(b)/(c) Waiver (Barnhart, Burr, Insko Sponsors). HB 916 seeks to expand the waiver statewide by July 1, 2013, and sets out specific requirements for the expansion of this managed care behavioral health Medicaid waiver: accountability for the development of a local system that ensures easy access to care, availability and delivery of necessary services, and continuity of care; fidelity to the PBH model; designate entities to manage the waiver through either merged LMEs or through interlocal agreement among LMEs; use of managed care strategies to reduce escalating costs in Medicaid while ensuring medically necessary care and deploy a system for the allocation of resources based on reliable assessment of intensity of need; phase out the CAP-MR/DD waiver; and design the Innovations waiver to serve the maximum number of individuals with intellectual and developmental disabilities within aggregate funding. It also specifies that county governments will not be financially liable for overspending or cost overruns associated with the operation of the waiver (i.e., the risk doesn’t shift). HB 916 specifies a number of conforming statute changes regarding the size of LMEs. Section 4 also exempts the Department from rulemaking in implementing, operating, or overseeing new Medicaid waiver programs or amendments to existing Medicaid waiver programs. It was introduced in the House this week and referred to the House Health and Human Services committee, and then to Finance.

HB 923, Local Inpatient Psychiatric Bed Assessment (Insko Sponsor). HB 923 seeks to increase the assessment on hospitals to provide additional funding for local inpatient psychiatric beds. It was introduced in the House last week and has been referred to the House Health and Human Services committee, then to Finance and Appropriations.

Action on Bills Previously Filed:

HB 397, DHHS Penalties and Remedies Revision (Lewis Sponsor). HB 397 seeks to amend facility penalty provisions under 122C, 131D and 131E to split Type A violations into Type A1 (violations that result in result in death or serious physical harm, abuse, neglect, or exploitation) and Type A2 violations (violations that result in substantial risk that death or serious physical harm, abuse, neglect, or exploitation will occur). HB 397 had been referred to House Finance because of the penalties imposed by the legislation. However, the bill was withdrawn from committee this week and voted on by the full House without any changes. The vote was 115-1, with Representative Collins (R-Nash) the sole No vote. The bill will now proceed in the Senate.

HB 423, Enact First Evaluation Program (Hurley Sponsor) (Senate version: SB 437 (Hartsell Sponsor)). HB 423 seeks to codify a practice that has been piloted that allows the Secretary to waive the requirements for a physician or eligible psychologist to perform the initial examination for involuntary commitment and substitute a licensed clinical social worker, a master's level psychiatric nurse, or a master's level certified clinical addictions specialist at the request of an LME. HB 423 is scheduled to be heard in the House Health and Human Services subcommittee on Mental Health next week on Tuesday, May 10.

HB 474, Protect Adult Care Home Residents (Weiss, Hollo, Farmer-Butterfield, Earle Sponsors). HB 474 proposes changes to Chapter 131D governing adult care homes to increase minimum continuing education, training, competency evaluation and inspection requirements for Adult Care Home medication aides, related to Infection Control Requirements. After receiving approval from the House, HB 474 has been received in the Senate and referred to the Senate Health care committee.

HB 509, Exclusions from Licensure: Home Services (Hurley Sponsor). HB 509 seeks to allow people with disabilities who receive MH/DD/SA services to live together as roommates without their home being considered a facility for licensing purposes. Specifically, it excludes from licensure: “A home in which up to three adults, two or more having a disability, co own or co rent a home in which the persons with disabilities are receiving three or more hours of day services in the home or up to 24 hours of residential services in the home. The individuals who have disabilities cannot be required to move if the individuals change services, change service providers, or discontinue services.” After receiving approval from the House, HB 509 has been received in the Senate and referred to the Senate Health Care committee.

HB 808, Revise Laws on Adult Care Homes (Burr). HB 808 seeks to waive annual inspections of Adult Care Homes that achieve the highest rating, and to develop an informal dispute resolution procedure that allows Adult Care Homes to dispute cited inspection deficiencies. The intent of the department is to focus more time on the homes with more problems. After receiving approval from the House, HB 808 has been received in the Senate and referred to the Senate Health Care committee.

SB 401, ACH Pilot on Crisis Intervention Training (Sponsors). SB 401 directs the Division of MH/DD/SAS to coordinate a pilot program in 10 adult care homes identified as having a significant percentage of residents with a primary diagnosis of mental health problems and where crisis management has been a concern in the past to evaluate the effectiveness of crisis intervention training. It also directs the Division to consider modification of the current North Carolina Interventions (NCI) Prevention training to a one-day training program appropriate for adult care home staff, including personal care aides, medication aides, and supervisors employed by the participants in the pilot program. After receiving approval from the Senate, SB 401 has been received in the House and referred to the House Health and Human Services committee.

SB 421, GAST Training Pilot (Bingham Sponsor). SB 421 directs the DHHS Division of MH/DD/SAS to establish a pilot training program using Geriatric/Adult Mental Health Specialty Teams to conduct training in Adult Care Homes on preventing the escalation of behaviors leading to crisis, based on a recommendation of the NC Institute of Medicine Task Force on the Co-Location of Different Populations in Adult Care Homes. After receiving approval from the Senate, SB 421 has been received in the House and referred to the House Health and Human Services committee.

SB 498, Modify Law re: Corporal Punishment (Pate, Purcell Sponsors). SB 498 seeks to amend the law related to corporal punishment of children in public schools to restrict corporal punishment only to students whose parent or guardian has stated in writing that corporal punishment may be administered on that student (an Opt-in). The bill received a favorable report from the Senate Education committee several weeks ago, but ran into some opposition from the NC Family Policy Council when it was set to be heard in the full Senate. The Family Policy Council, which is dedicated to the preservation of the family and traditional family values, objected to the opt-in procedure of the bill, which, oddly enough, gives parents the absolute right to decide whether their child will be subjected to corporal punishment. The bill was heard again in Senate Education this week where the opt-in procedure was changed to an opt-out. While this is disappointing, after the bill was passed last year allowing parents of children with disabilitis to opt-out, several more school districts banned corporal punishment, so this wider opt-out may lead to even more school districts abandoning the practice and certainly to less children being subjected to corporal punishment. The bill is scheduled to be voted upon in the full Senate next Tuesday, May 10.

SB 524, Strengthening Residential Placement (Tucker, Hartsell Sponsors) (HB 377 (Brisson Sponsor) was approved earlier in the session by the House Health and Human Services committee). SB 524 seeks changes to the budget special provision regarding the restructuring of Level III and IV mental health residential placements to add that an assessment shall be completed to ensure the appropriateness of placement before admission to such a placement; to extend the length of stay to 180 from 120 days (180 is the average length of stay); and to specify that the authorization approval is not conditional upon all signatures and that LMEs shall designate appropriate individuals who can sign the discharge plan within 24 hours of receipt. SB 524 received a favorable report from the Senate Mental Health committee this week and has been referred to the Senate Finance committee.

SB 607, Conform Medical Record Laws (Stein). SB 607 seeks to amend various sections in the General Statutes to make it easier to share currently protected health information, including information regarding mental health (See the April 18 and 25 bill update for more details about the bill and the changes made in the Senate). The bill was approved by the full Senate on Thursday, with an amendment providing that confidential information shared by a 122C facility shall not be used or disclosed for discriminatory purposes including, without limitation, employment discrimination, medical insurance coverage or rate discrimination, or discrimination by law enforcement officers.

SB 648, Amend Law Re: School Discipline (Preston; Tillman; Hartsell). SB 648 seeks to make a number of changes to Chapter 115C regarding school discipline with the goal of keeping students in school. It is a consensus bill supported by Disability Rights NC that numerous entities representing schools and students contributed to. It was approved by the Senate Education committee this week and will be voted on by the full Senate on Tuesday.

SB 669, Dix Property Mental Health Trust Fund (Atwater) SB 669 seeks to require that proceeds from any sale of the Dorothea Dix Hospital Property be placed in the State’s Trust Fund for Mental Health to be used for people with mental illness. The bill was approved by the Senate Committee on Mental Health & Youth Services on Wednesday, and will be voted on by the full Senate on Tuesday.

Bill Update for Weeks of April 18 and April 25

2011-04-30T09:27:00.000-04:00

HB 234, Juror Qualifications/Disabilities (Glazier, S. Stevens, Parfitt, Samuelson Sponsors). HB 234 seeks to amend the current Juror Qualifications statute to remove the ability to hear as a requirement to serve as a juror. It also seeks to amend the statute regarding Requests to be Excused from Jury Duty to allow potential jurors with a disability to request to be excused if the person feels that their disability could interfere with their ability to serve as a juror. It was signed by the Governor on April 19, Chaptered Session Law 2011 42.

HB 344, Tax Credits for Children with Disabilities (Stam, Randleman, Jordan and Jones Sponsors). The bill creates an individual income tax credit for families of children with disabilities who require special education and are attending a nonpublic school, in a public school at which tuition is charged, or homeschooled. It also creates a Fund for Special Education and Related Services. The bill received a favorable report from the House Education committee last week and will next be heard in the House Finance committee.

HB 397, DHHS Penalties and Remedies Revision (Lewis Sponsor). HB 397 seeks to amend facility penalty provisions under 122C, 131D and 131E to split Type A violations into Type A1 (violations that result in result in death or serious physical harm, abuse, neglect, or exploitation) and Type A2 violations (violations that result in substantial risk that death or serious physical harm, abuse, neglect, or exploitation will occur). The concerns that Disability Rights NC had with the bill were addressed and we do not oppose the bill. It received a favorable report from the House Judiciary A Committee, and will next be heard in House Finance.

HB 417, Extend Time for Site of Low/Moderate Income Housing (McGrady Sponsor). HB 417 seeks to extend the time, for tax purposes, that real property may be held by a non-profit organization as a future site for housing for individuals or families with low or moderate incomes fro m 5 to 10 years. It received a favorable report from the House Commerce committee and will next be heard in the House Finance committee.

HB 423, Enact First Evaluation Program (Hurley Sponsor); SB 437 (Hartsell Sponsor). HB 423 seeks to codify a practice that has been piloted that allows the Secretary to waive the requirements for a physician or eligible psychologist to perform the initial examination for involuntary commitment and substitute a licensed clinical social worker, a master's level psychiatric nurse, or a master's level certified clinical addictions specialist at the request of an LME. The House version was heard the week of 4/18 in the House Health and Human Services committee where the bill was amended to limit clinical addiction specialists to commitments involving substance abuse. The bill was scheduled to be heard in the full House last week but was pulled from the calendar and d referred back to the Health and Human Services committee.

HB 474, Protect Adult Care Home Residents (Weiss, Hollo, Farmer-Butterfield, Earle Sponsors). HB 474 proposes changes to Chapter 131D governing adult care homes to increase minimum continuing education, training, competency evaluation and inspection requirements for Adult Care Home medication aides, related to Infection Control Requirements. A committee substitute was approved by the House Health and Human Services committee and the full House last week.

HB 509, Exclusions from Licensure: Home Services (Hurley Sponsor). HB 509 seeks to allow people with disabilities who receive MH/DD/SA services to live together as roommates without their home being considered a facility for licensing purposes. The bill received a favorable report from House Health and Human Services and the full House this week. Thanks to Sponsor Representative Hurley!

HB 618, Streamline Oversight/DHHS Service Providers (Lewis, Hurley sponsors) (SB 525 was also filed). HB 618 seeks to streamline duplicate oversight of DHHS service providers. The bill was heard but not voted on in the House Health and Human Services committee the week of April 18. Because of the number of questions and concerns about this bill, the sponsor agreed to postpone a vote to allow the interested groups, including Disability Rights NC, to work out their differences.

HB 659, Capital Procedure/Severe Mental Disability (Stevens, Glazier, McGrady, Harrison Sponsors). This a Disability Rights NC agenda bill. It seeks to amend the capital trial, sentencing and postconviction procedures for a person with a severe mental disability to address the issue upfront in trial, and to remove the death penalty as the highest punishment if the individuals qualifies as a person with severe mental disability under the law. It also seeks to provide that Not Guilty by Reason of Insanity is not an available defense if prior alcohol or drug use are the sole cause of the psychosis. It received a favorable report from the House Judiciary B committee the week of April 18 and will next be heard by the House Appropriations committee.

HB 734, Require Photo ID/Food Stamps Program (Warren, Brown, Lewis, Moore Sponsors). HB 734 seeks to require DHHS to issue debit cards that contain photo identification on the card for participants in the Supplemental Food and Nutrition Program (SNAP). A committee substitute was approved by the House Judiciary C subcommittee, and, will next be heard in Finance.

HB 736, Amend Law re: School Discipline (Langdon, Luebke, Daughtry, Lucas Sponsors). HB 736 seeks to make a number of changes to Chapter 115C regarding school discipline with the goal of keeping students in school. A committee substitute received a favorable report the week of April 18 and the bill was approved by the full House this week. As amended, the bill makes clear that the local board of education, in its discretion, may provide students an opportunity for a review or appeal of a short term suspension to the superintendent or local board of education. The bill now proceeds to the Senate.

HB 808, Revise Laws on Adult Care Homes (Burr Sponsor). HB 808 seeks to waive annual inspections of Adult Care Homes that achieve the highest rating, and to develop an informal dispute resolution procedure that allows Adult Care Homes to dispute cited inspection deficiencies. The intent of the department is to focus more time on the homes with more problems. A committee substitute received a favorable report from the House Health and Human Services committee, and passed 2d reading in the full House this week.

SB 33, Medical Liability Reforms (Rucho, Apodaca, Brown sponsors). SB 33 seeks to limit medical liability claims through several reforms including a higher standard for liability when providing emergency medical care, ordering bifurcation upon motion of any party, and limiting the amount of noneconomic damages that may be awarded. The bill was heard and voted on favorably in the full House the week of April 18. Last week, the Senate voted on whether to concur the House committee substitute, which failed. The House and Senate will now negotiate their differences in a conference committee.
SB 328, Report on Transfer of CAP-MR/DD UR to LMEs (Nesbitt Sponsor). HB 75 seeks to require a report of DHHS to the Legislative Oversight Committee on MH/DD/SAS on the implementation of Utilization Review by designated LMEs for services provided under the CAP-MR/DD program. The report is to include a cost comparison and a report on accountability measures used by the LMEs to ensure the accuracy of the decisions. The bill received a favorable report from the Senate Mental Health committee, and will next be heard in Appropriations.

SB 334, Expand Inpatient Psychiatric Beds/Funds (Nesbitt Sponsor). SB 334 seeks $39 million for the expansion of local inpatient psychiatric beds or bed days, as recommended by the MH/DD/SAS Legislative Oversight Committee. The bill received a favorable report from Senate Mental Health, and will next be heard in Appropriations.

SB 335, Apply for TBI Medicaid Waiver (Nesbitt Sponsor). SB 335 directs the DHHS to apply for a 1915(c) Medicaid waiver, in consultation with the North Carolina Traumatic Brain Injury Advisory Council, to permit persons who sustain traumatic brain injuries to access home and community based Medicaid services. The Department shall not submit the application to CMS unless the General Assembly identifies a source of funding sufficient to provide the match for this proposed waiver from State appropriations earmarked for persons with traumatic brain injury. The bill received a favorable report from Senate Mental Health, and will next be heard in Appropriations.

SB 401, ACH Pilot on Crisis Intervention Training (Bingham Sponsor). SB 401 directs the Division of MH/DD/SAS to coordinate a pilot program in 10 adult care homes identified as having a significant percentage of residents with a primary diagnosis of mental health problems and where crisis management has been a concern in the past to evaluate the effectiveness of crisis intervention training. It also directs the Division to consider modification of the current North Carolina Interventions (NCI) Prevention training to a one-day training program appropriate for adult care home staff, including personal care aides, medication aides, and supervisors employed by the participants in the pilot program. The bill is based on Recommendation 5.2 from the North Carolina Institute of Medicine Task Force on the Co Location of Different Populations in Adult Care Homes and as Recommended by the North Carolina Study Commission on Aging. The bill received a favorable report from the Senate Mental Health committee and the full Senate last week.

SB 421, GAST Training Pilot (Bingham Sponsor). SB 421 directs the DHHS Division of MH/DD/SAS to establish a pilot training program using Geriatric/Adult Mental Health Specialty Teams to conduct training in Adult Care Homes on preventing the escalation of behaviors leading to crisis, based on a recommendation of the NC Institute of Medicine Task Force on the Co-Location of Different Populations in Adult Care Homes. It received a favorable report from the Senate Mental Health committee and the full Senate last week.

SB 474, Photo ID for Certain Controlled Substances (Apodaca, Hise Sponsors). SB 374 seeks to direct pharmacies to require photo identification prior to dispensing Schedule II Controlled Substances. Schedule II includes a number of drugs for pain relief, and amphetamine substances (like Adderall). A committee substitute that added some Schedule III substances was adopted by the Senate Judiciary I committee, and the bill was approved by the full Senate. It will next be heard in the House Judiciary committee.

SB 498, Modify Law re: Corporal Punishment (Pate, Purcell Sponsors). SB 498 seeks to amend the law related to corporal punishment of children in public schools to restrict corporal punishment only to students whose parent or guardian has stated in writing that corporal punishment may be administered on that student (an Opt-in). The bill received a favorable report from the Senate Education committee several weeks ago, but ran into some opposition from the NC Family Policy Council when it was set to be heard in the full Senate. The Family Policy Council, which is dedicated to the preservation of the family and traditional family values, objected to the opt-in procedure of the bill, which, oddly enough, gives parents the absolute right to decide whether their child will be subjected to corporal punishment. The bill is likely to proceed with an opt-out, instead of an opt-in for parents (i.e., if a parent does not respond on the form that is sent home about corporal punishment, the school will take that as agreement from the parent that their child may be subjected to corporal punishment.).

SB 607, Conform Medical Record Laws (Stein). SB 607 seeks to amend various sections in the General Statutes to make it easier to share currently protected health information. The bill as filed allows service providers to share confidential information to coordinate (which means the provision, coordination, or management of MH/DD/SA services and includes the referral of a client from one facility to another) to coordinate appropriate and effective care, treatment or habilitation of the client. Before making such disclosures, the provider shall inform the client that the facility may make such disclosures unless the client objects in writing. If the client objects in writing, the disclosures are prohibited. A covered entity receiving confidential information under this provision may use and disclose the information when necessary to conduct quality assessment and improvement activities or to coordinate appropriate and effective care, treatment, or habilitation of the client. This language was a compromise reached among the provider community, DHHS and advocates. However, despite an understanding on the compromise language, Community Care of North Carolina and the NC Medical Society lobbied Senator Stein to change the language to allow disclosure of confidential information for any HIPAA purpose, not just for the limited purposes of conducting quality assessment and improvement activities or to coordinate appropriate and effective care, treatment, or habilitation of the client. Despite the objections of Disability Rights NC, Senator Stein proceeded with the language proposed by CCNC and the Medical Society. There were comments on both sides in the committee – the focus of those seeking broader disclosure is simply to make it easier for physicians to share confidential information about patients. Disability Rights NC and NAMI NC spoke in favor of limiting purposes for disclosure on the grounds that broad disclosure could be detrimental to patients with mental health disabilities that unfortunately remain greatly stigmatizing, and could serve as a disincentive to patients to even seek treatment. The committee gave the bill a favorable report with the understanding that the sponsor would continue to work with us. However, as of right now, the bill is scheduled for Monday evening. Disability Rights NC continues to advocate for limited disclosure of protected mental health information.

House Budget Update

2011-04-28T15:21:00.000-04:00

The full House Appropriations committee met in a marathon session on Wednesday to consider the full House budget proposal. The committee met for 7 hours and voted on 70 amendments. The amendments are online here. The Money Report is here, and the Special Provisions are here. Thanks to our new Policy Analyst Corye Dunn for covering the Appropriations Committee yesterday! The full House will vote on the budget next week. The budget will then go to the Senate, and finally the two chambers will work out their differences before sending the budget to the governor.

A few points on the amendments:

Residential Schools for the Deaf and Blind (Page F6 of Money Report) - this change was actually made before yesterday but we didn't note previously: when the Education subcommittee eliminated the full-time Superintendent position, the money saved did go back into the schools overall budget, reducing the amount of overall reductions to the schools from $1.7 mil to $1.55 mil.
There was an amendment (by Representative Glazier) to ensure that there would be no elimination of positions in the Positive Behavior Support program at the Department of Public Instruction.
There was an amendment (by Representative Burr) to allow the department the flexibility of adjusting Medicaid provider rates prior to October 1.
There was a motion made by Representative Ingle to close Samarkand Youth Development Center the second year of biennial instead of the first, but the amendment failed.
There was an amendment (by Representative Dollar) that allows funds allocated to LMEs for community mh/dd/sa services to be used to purchase additional local inpatient beds, at the discretion of the Secretary.
Another amendments (by Representative Torbett) moved money from the Housing Trust Fund, an essential resource for affordable housing in NC, to the Department of Cultural Resources.
Representative Dollar also moved for an amendment to continue exception to pre-authorization requirements for prescriptions related to the treatment of mental illness and HIV/AIDS.

After the full budget passes the House next week, we will provide a summary and highlight the issues of greatest concern to us.

Together NC Speak NC Series

2011-04-25T21:35:00.000-04:00

Disability Rights NC is a member of Together NC. We’re excited to share the release of the third installment of the Speak NC series - http://www.speaknc.org/2011/04/speech-therapist/.

The video is a poignant reminder about the power of communication and the importance of services like speech therapy in North Carolina. Unfortunately, with legislators proposing hundreds of millions of dollars to cuts in Medicaid, it’s unclear whether or not many of North Carolina’s speech therapists will be able to stay in business.

Below is the press release that went out with the video earlier this morning:
New video spotlights importance of North Carolina speech therapists

The weekly videos from Together NC’s Speak NC campaign document individuals, families, and groups who rely on state services
RALEIGH (April 25, 2011) – A powerful new video released today spotlights how state speech therapists change lives for the better. The Speak NC video, released by the Together NC coalition, is part of a campaign documenting the positive impact of state programs and services on families and communities throughout North Carolina.

The ability to communicate is an integral part of getting an education, building relationships and finding a job. That’s why North Carolina chooses to provide speech therapy services through its Medicaid program. The video follows one such speech therapist, Allison Crumpler from Raleigh.

Specifically, North Carolina’s speech therapists work with patients on a wide variety of issues, including articulation disorders, stuttering, auditory comprehension disorders, expressive communication disorders, swallowing disorders, voice disorders, and literacy and written language disorders.

Currently, there are over 5,600 licensed speech therapists in North Carolina, but with legislators proposing hundreds of millions of dollars of cuts in Medicaid, it’s unclear whether or not many of North Carolina’s speech therapists will be able to stay in business.

The video is the third in a series produced by Together NC. The videos highlight North Carolina residents who benefit from vital public investments. The videos are available on the new Speak NC website. Speak NC aims to show the human impact of state programs and services that touch thousands of North Carolinians every year.

Each Monday, Speak NC will post a new video that documents how an individual, family, or group of people benefits from various state services. Many of these services are at risk of severe cuts, as state legislators meet at the General Assembly and strategize how to balance the state budget.

“Missing from our state budget debate was a real sense of how state services impact real people, their families, and communities amidst all the numbers,” said Louisa Warren, a coordinator of Together NC. “Speak NC is about changing that and bringing forth the voices of North Carolinians to speak for themselves about how public investments have enriched their lives and paved the way for economic opportunity.”

Together NC invites citizens to watch the stories on Speak NC and share them with friends, family, and local legislators to demonstrate how many of these programs provide crucial aid to families and bolster local economies.

Visit Speak NC at www.speaknc.org

Bill Update for the Week of April 18 - New bills filed

2011-04-25T21:27:00.000-04:00

The Senate bill filing deadline was last week. Summaries of the bills relevant to people with disabilities from this last batch of bills are below. An update of action on previously filed bills will be forthcoming.

SB648 AMEND LAW RE: SCHOOL DISCIPLINE (Preston; Tillman; Hartsell) SB 648 is the Senate version of HB 736, which is proceeding through the House. The bill has been referred to the Senate Committee on Education.

SB650 SPENDING REDUCTION WITH MEDICAL HOUSE ARREST (Vaughan ) SB 650 would authorize a Sheriff to place certain defendants or prisoners on medical house arrest with electronic monitoring in lieu of confinement to the local confinement facility and to authorize the post release supervision and parole commission to release certain prisoners who require ongoing major medical treatment on medical release, provided the prisoner is placed on house arrest with electronic monitoring. The bill has been referred to the Senate Committee on Judiciary II.

SB654 WC/ADJUST ORGAN INJURY BENEFIT ANNUALLY (Goolsby; Newton; Daniel) SB 654 would amend the workers' compensation act to provide for the annual adjustment of the benefit for permanent injury to an important bodily organ. This bill has been referred to the Senate Committee on Judiciary I.

SB656 RIGHT TO CHOOSE PHYSICAL THERAPIST (Davis) SB 656 seeks to ensure that patients have the right to choose their physical therapists under their health benefit plans. The bill has been referred to the Committee on Insurance.

SB657 VOTING INTEGRITY (Davis; Daniel; Hise) SB 657 is one of several bills aimed at changing voting procedures including absentee voting, one-stop early voting, and registration for new voters. This bill would make it more difficult for newly-eligible young voters to participate in elections and narrows the times and places at which one-stop voting can be conducted, among other provisions. Disability Rights NC opposes any legislation that is likely to reduce the electoral participation of people with disabilities, a group that already votes at rates 10-15% lower than the rest of the population. The bill has been referred to Senate Committee on Judiciary I.

SB669 DIX PROPERTY MENTAL HEALTH TRUST FUND (Atwater) SB 669 seeks to require that proceeds from any sale of the Dorothea Dix Hospital Property be placed in the State’s Trust Fund for Mental Health. The bill was referred to the Senate Committee on Mental Health & Youth Services.

SB674 CIVIL JUSTICE SYSTEM REFORMS (Brunstetter; Brown, H.; Rucho) SB 674 seeks to reduce the amount of money a plaintiff is eligible to recover in a civil law suit by allowing evidence of payments made, on behalf of the plaintiff, for any medical expenses or other damages the plaintiff is seeking. Most notably the bill eliminates the state’s long history of joint and several liability in civil cases where more than one person is at fault. This places the risk on the shoulders of the person who is least able to bear it, the one who has been injured. The bill also limits the scope of testimony admissible from an expert witness; limits the attorney fees that can be awarded to a plaintiff; and limits the liability of people in possession of land when a trespasser is injured. The bill has been referred to Senate Committee on Judiciary I.

SB697 PATIENT ADVOCACY & PROTECTION ACT (Stein) SB 697 would prohibit an employer from retaliating against a nurse who makes a good faith report concerning patient medical care or who engages in patient advocacy. The bill would also protect anyone who advises a nurse about the right to make a good faith report or engage in patient advocacy. The bill has been referred to the Senate Committee on Rules.

SB707 SCHOOL VIOLENCE PREVENTION ACT (Tucker) SB 707 seeks to require school superintendents to report many acts, including assault resulting in serious personal injury, sexual assault, sexual offense, rape, kidnapping, indecent liberties with a minor, assault involving the use of a weapon, possession of a firearm in violation of the law, possession of a weapon in violation of the law, or possession of a controlled substance in violation of the law that occur on school grounds to local law enforcement. The bill also requires that the local board of education or superintendent shall expel, or remove to an alternative education setting, any student who has been convicted of a felony, adjudicated delinquent for an offense that would be a felony if committed by an adult, arrested two or more times, or alleged to be delinquent or undisciplined two or more times. These proposed changes to the law would disproportionately affect students with disabilities and would reinforce the school to prison pipeline that is already a problem. While the above items cause Disability Rights NC grave concern, the bill goes further to relieve school personnel of liability for using force to correct pupils and maintain order in the schools or for failing to intervene in an altercation between students creating the likelihood of real danger for students in North Carolina schools. Disability Rights NC is opposed to the bill. The bill has been referred to the Senate Committee on Judiciary II.

SB714 SATELLITE EARLY VOTING MINIMUM TIMES (Nesbitt) SB 714 would require that in general elections within each county all satellite early voting sites are open at least the same number of days and hours each week as the board of elections office site. The bill has been referred to Senate Committee on Judiciary I.

SB717 PHOTO I.D. FOR SNAP RECIPIENTS (Mansfield) SB 717 would require the Department of Health and Human Services to issue debit cards to access Supplemental Food and Nutrition Program (SNAP) that include photo identification of the recipient. The bill has been referred to the Committee on Agriculture.

SB724 AN ACT TO IMPROVE PUBLIC EDUCATION (Stein, Tillman) SB 724 would make a number of changes. First it would increase the course requirements and the years of study required by UNC system teacher training programs, require prospective elementary school teachers in those programs to complete courses in teaching reading and mathematics, and increase requirements for technology and evaluation coursework. The bill would require local boards of education to create and implement plans for the transition of at-risk students from elementary to middle school and from middle to high school. The 25 schools with the highest dropout rates would have both longer school days and longer school years. Additionally the State Board of Education would be required to reconsider the high school graduation requirements for those students who do not plan to continue their education beyond high school possibly to include a five-year plan to complete graduation requirements and/or a change in those graduation requirements. The bill has been referred to the Committee on Education.

SB744 TRANSPARENCY IN THE COST OF HEALTH CARE (Goolsby) SB 744 would allow employers to access data regarding the usage of their group health coverage on an aggregate basis and on an individual basis for those employees who incurred more than $15,000 of total, paid claims. The data would include diagnostic codes, procedure codes, prognosis, and, for anyone in active case management, future expected costs. While the information would be provided without the name of the insured, that is not sufficient protection. This bill would violate the privacy of employees’ medical records and the records of their families. It would also make it easier for employers to discriminate against employees who have serious health problems or whose family members require significant medical care. The bill has been referred to the Committee on Health Care.

SB754 CAREGIVER RELIEF ACT (McKissick) SB 754 would expand the protections afforded under the federal Family and Medical Leave Act to caregiving for a sibling, grandparent, grandchild, stepparent, or parent-in-law. Disability Rights NC supports this bill. The bill has been referred to the Committee on Rules.

House Budget Update

2011-04-25T20:57:00.000-04:00

House Appropriation subcommittees voted on their budgets last week. Refer to earlier posts for a summary of the proposals. The full Appropriations committee will consider the budget this week, and the full House will likely vote next week.

Major changes to the HHS budget:

The most recent version of the HHS budget is online here with the addition of the 3 amendments that are listed here.
The special provision amending the Medicaid appeals process has been removed. Only a short provision remains directing DHHS to review the appeals process for adverse Medicaid determinations for recipients to examine whether it conforms with, or exceeds, the requirements of federal law. This is good news.
Change in community service funds provision: The provision prohibiting state funded community services for all Medicaid recipients was removed.
Eliminated LME administration funding reduction ($10 mil first year, $20 mil second). We are extremely disappointed that the committe chose to restore the administration funding and not the funding for services. There is also a new special provision regarding the transition of Utilization Management (UM) of Community-based services to LMEs, directing DHHS to collaborate with LMEs to enhance their administrative capabilities to assume UM for community based MH/DD/SA services.
The committee made several amendments related to increased savings estimates over their original numbers, including, additional savings from an increased rate of generic drugs, increased savings from the 1915 b/c behavioral health waiver from $3.2 mil to $10.5 mil, and increased CCNC savings from $80 mil to $90 mil in the first year.
There was a slight decrease in provider rate adjustments, and the addition of CABHAs (Critical Access Behavioral Health Agencies) to the list of providers exempt from the provider rate reduction.
There was a smaller reduction to Independent Living (IL) in Vocational Rehabilitation – brought back to Gov’s proposal.
Dropped Items: special adoption assistance vendor payments, child welfare education collaborative, prioritize senior funding, reduce HCCBG, reduce medical eye program by 12%
There is a new special provision regarding Child and Family Teams.
There is a new special provision regarding state-county special assistance in adult care homes.

Educations Appropriations Subcommittee

The subcommittee recommendation still includes cuts across the board for education funding. K-12 education is cut by approximately 8.8% compared to the 2011-2012 Continuation Budget. Community colleges are cut by approximately 10.1% compared to the 2011-2012 Continuation Budget. The UNC System is cut by approximately 15.5% compared to the 2011-2012 Continuation Budget. Of particular interest to Disability Rights NC is language codifying the move of North Carolina’s residential schools from the Department of Health and Human Services to the Department of Public Instruction. The subcommittee also adopted an amendment by Chairman Blackwell that would:

1) Eliminate the position of superintendent for the residential schools from the Department of Public Instruction, instead requiring that one of the directors of the residential schools be designated to serve as superintendent with a salary supplement of $20,000;

2) Allow for the creation of principal positions at each school but deny any additional funding for those positions;

3) Retain the pre-February 8, 2010 residential and instructional schedules, requiring that students be bused to school on Monday mornings instead of Sunday evenings, stay in place; and

4) Prohibit the Department of Public Instruction from closing the residential schools or consolidating their operations unless and until the General Assembly instructs the Department to do so.

Stay tuned for more updates as the budget proceeds.

Help the FCC Improve 9-1-1 Services for People With Disabilities

2011-04-20T14:50:00.003-04:00

The Federal Communications Commission (FCC) is seeking input from people with disabilities to improve 9-1-1 emergency services. Help the FCC understand the needs of people with disabilities by taking their NG911 survey.

To take the emergency access NG911 survey, click on one of the options below. This survey will be available until April 24, 2011.

Survey in English and ASL

Encuestra en Español

Easy to Read Version

Bill Update for the Week of April 11

2011-04-16T15:43:00.000-04:00

Bills Previously Filed with Action Last Week:

HB 30, Allow Wage Garnishment to Satisfy Judgments (Moore Sponsor). As originally filed, this bill would drastically expand wage garnishment for judgments. However, a Proposed Committee Substitute with a much limited scope was moved forward this week in the House Judiciary C committee. This version only seeks wage garnishment for violation of unfair trade practices, which alleviated our concerns about its impact on people with disabilities. It will next be heard in the House Finance committee.

HB 234, Juror Qualifications/Disabilities (Glazier, S. Stevens, Parfitt, Samuelson Sponsors). HB 234 seeks to amend the current Juror Qualifications statute to remove the ability to hear as a requirement to serve as a juror. It also seeks to amend the statute regarding Requests to be Excused from Jury Duty to allow potential jurors with a disability to request to be excused if the person feels that their disability could interfere with their ability to serve as a juror. The bill was on the calendar in the House for concurrence on Monday evening. The House voted 113-4 to concur (Boles, Daughtry, Iler and Stone voted against concurrence).

HB 377, Strengthening Residential Placement (Brisson Sponsor). HB 377 seeks changes to the budget special provision regarding the restructuring of Level III and IV mental health residential placements to add that an assessment shall be completed to ensure the appropriateness of placement before admission to such a placement; to extend the length of stay to 180 from 120 days (180 is the average length of stay); and to specify that the authorization approval is not conditional upon all signatures and that LMEs shall designate appropriate individuals who can sign the discharge plan within 24 hours of receipt. HB 377 received a favorable report from the House Health and Human Services committee this week. Despite the average stay of 180 days, the Department objected to this change, and there was a fair amount of discussion. However, the committee passed the language with the 180 day change. Additionally, this language has been incorporated into the House Health and Human Services Appropriations budget language.

HB 595, Reorganization/Legislative Oversight Comns (Barnhart, Burr Sponsors). HB 595 proposes a new structure for the numerous legislative committees and commissions, including establishing a Joint Legislative Oversight Committee on Health and Human Services, which merges the Study Commission on Aging, the Joint Legislative Health Care Oversight Committee, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, and the Public Health Study Commission. HB 595 has successfully passed through the House and will now be referred to the Senate.

HB 614, DMA Post Public Notices of Change on Website (Murry, Dollar, Brisson Sponsors). HB 614 seeks to require the Department of Health and Human Services to publish on its web site public notices of changes in statewide methods and standards for setting medicaid payment rates. It has successfully passed through the House and has been referred to the Senate Healthcare committee.

SB 8, No Cap on Number of Charter Schools (Stevens sponsor). This bill eliminates the existing cap of 100 charter schools and makes a number of changes to the existing statute governing charter schools. The bill passed the House this week and was referred back to the Senate. The Senate failed to concur with the changes made in the House and a conference committee has now been appointed.

SB 394, Clarify Process/Reportable Offenses in Schools (Newton, Tillman, Preston Sponsors). SB 394 seeks to amend the statute (115C-288(g)) regarding principal reporting of certain acts to law enforcement. A Proposed Committee Substitute (PCS) was heard in the Senate Judiciary I committee on April 7. The PCS changed the consequences for a principal’s failure to report an offense under the section from a Class 3 misdemeanor to demotion or dismissal. It still makes clear that the State Board of Education shall not require the principal to report to law enforcement acts in addition to those required to be reported by this subsection. There was a concern that additional offenses would be added to the list mandated to be reported, which Disability Rights NC has opposed in the past. However, the bill received a favorable report from the committee and a unanimous vote by the full Senate, without change. It now proceeds to the House.

SB 437, Enact First Evaluation Program (Hartsell Sponsor). SB 437 seeks to codify a practice that has been piloted that allows the Secretary to waive the requirements for a physician or eligible psychologist to perform the initial examination for involuntary commitment and substitute a licensed clinical social worker, a master's level psychiatric nurse, or a master's level certified clinical addictions specialist at the request of an LME. When making and considering the request, certain criteria must be addressed. The proposed statutory language also specifies that the waiver shall be for 3 years and the LME shall assure that a physician is available at all times to provide backup support to include telephone consultation and face to face evaluation, if necessary. A Proposed Committee Substitute for SB 437 was heard in the Senate Healthcare committee this week. The PCS adds licensed professional counselors to the list of practitioners who may conduct the examinations and clarifies that master’s level certified clinical addiction specialists are only authorized to conduct the initial examination of individuals for whom commitment is being sought based on substance abuse. The committee approved the PCS and the bill is scheduled to be heard on Monday evening in the Senate.

SB 498, Modify Law re: Corporal Punishment (Pate, Purcell Sponsors). SB 498 seeks to amend the law related to corporal punishment of children in public schools to restrict corporal punishment only to students whose parent or guardian has stated in writing that corporal punishment may be administered on that student. Parents and guardians shall be given a form to make such an election at the beginning of the school year or when the student first enters the school during the school year. SB 498 received a favorable report from the Senate Education committee this week and will be heard in the full Senate on Monday evening.

Newly Filed Bills:

HB 862, Election Integrity/Voter Access Act (Hall, Owens, Spear, Hill Sponsors). HB 862 would require voters to produce valid photo identification, a current utility bill, bank statement, government check, paycheck, or other government document. If the voter is unable to produce such identification, he or she must sign an affidavit stating the voter’s name, date of birth, and address with a clear statement that knowingly making a false statement is a Class I felony. It is the Democrats’ version of the voter identification bill. Whether this bill proceeds will likely depend upon what happens with HB 351. It has been referred to the House Elections committee.

HB 863, Behavioral Health Services For Military/Funds (Martin; Parfitt; Hall Sponsors) (SB597 (Purcell Sponsor) was also filed in the Senate). HB 863 would require LMEs and schools to make certain staffing and procedural changes to ensure that care for members of the military, veterans, and their families, whose care is funded through federal programs is coordinated appropriately. It has been referred to the House Appropriations committee.

HB 866, Transition Residential Schools To Department Of Public Instruction (Insko; Glazier Sponsors). HB 866 codifies the transfer of control of the state’s Residential Schools (the Governor Morehead School for the Blind, the Eastern North Carolina School for the Deaf in Wilson, and the North Carolina School for the Deaf in Morganton). The State Board of Education would be required to promulgate rules providing for: 1) codes of conduct and appeals provisions for students, 2) Policies and procedures for academic performance and academic discipline, and 3) reasonable fees and charges for extracurricular activities, transportation for extracurricular activities, and athletics. The bill would also require that each school establish a “Student Rights Advisory Committee” to monitor, review, and evaluate programs and procedures related to student rights, safety, security, and quality of life and to review data and make recommendations regarding cases of alleged abuse, neglect, exploitation, or student rights violations arising from actions or policies of the school or its staff. This section on the Student Rights Advisory Committees is intended to codify the committees currently knows as Human Rights Committees. The bill also seeks funding to bring back the 3 principal positions at the schools and 3 positions to support the Executive Director (now known as the Superintendent). Disability Rights NC worked with DPI, and others on this legislation and we support the bill. It is our understanding that advocates for the schools still have some remaining concerns. It has been filed in the House but not yet referred to a committee.

SB 551, Establish State Public Health Authority (Hartsell Sponsor). SB 551 would decentralize public health functions from the state level except for the State Lab, Vital Records, Medical Examiner, and Public Health Emergency Response. Authority for all other responsibilities currently vested in the Department of Public Health would reside with four Regional Public Health Authorities and an Institute for Public Health Improvement. Counties could, at their election, select a regional authority to serve as the public health department for the county. The Institute for Public Health Improvement would administer the four regional authorities and receive all state and federal funds for public health. It has been referred to the Senate Healthcare committee.

SB 574, Senior Or Disabled Care Tax Credit (Robinson Sponsor). SB 574 seeks to provide a tax credit for training, supplies, and transportation costs incurred in caring for an elderly or disabled family member. It has been referred to the Senate Finance committee.

SB 578, LME Minimum Population (Hartsell). SB 578 seeks to set a minimum threshold for the population of the catchment area of a LME - to 300,000 by July 1, 2012 and 500,000 by July 1, 2013. It has been referred to the Senate Mental Health committee.

SB 595, Voter Identification At Polls (Clary). SB 595 is the Senate companion bill to the House Voter ID bill, HB 351. It would require voters to produce valid photo identification in order to vote. It would also require county boards of elections to make voter identification cards including a photo and other personal information available, without a fee, to any voter who does not have a valid driver’s license or state identification card. This bill would allow for voters without the required identification to vote a provisional ballot. The bill would also waive the fee for Special Identification Cards produced by the DMV for those who are blind, over age 70, homeless, or lack other valid photo identification but are registered to vote. It has been referred to the Senate Judiciary I committee.

SB 607, Conform Medical Record Laws (Stein). SB 607 seeks to amend various sections in the General Statutes to make it easier to share currently protected health information. The legislation was developed in conjunction with the SB 375 setting up the statewide Health Information Exchange (HIE). Information shared through the HIE may be shared for all HIPAA permitted purposes. However, there are several state laws that provide for stricter standards for the disclosure of information than HIPAA. This bill attempts to bring these two standards closer together. Of particular interest to Disability Rights NC is the provision seeking to revise exceptions to confidentiality under 122C, which covers MH/DD/SA service providers. The bill allow service providers to share confidential information to coordinate (which means the provision, coordination, or management of MH/DD/SA services and includes the referral of a client from one facility to another) to coordinate appropriate and effective care, treatment or habilitation of the client. Before making such disclosures, the provider shall inform the client that the facility may make such disclosures unless the client objects in writing. If the client objects in writing, the disclosures are prohibited. A covered entity receiving confidential information under this provision may use and disclose the information when necessary to conduct quality assessment and improvement activities or to coordinate appropriate and effective care, treatment, or habilitation of the client. This language is a compromise reached among the provider community, DHHS and advocates, which Disability Rights NC has agreed not to oppose. We will be following this legislation closely. It has been filed in the Senate but not yet referred to a committee.

SB 624, Modify Hearing & Mailings for Rule Making (Preston). SB 624 seeks to require state agencies to increase notice to counties and the public of proposed rules by 1) notifying county governments of proposed rules that will affect their county, 2) publishing notice in at least one newspaper in each affected county of how to access the text of the proposed rule by internet, and 3) holding public hearings within 60 miles of each affected county where a resident has requested a hearing in writing. It has been filed in the Senate but not yet referred to a committee.

More on House Health and Human Services and Education Appropriations Proposals

2011-04-15T08:10:00.000-04:00

Here is a really brief rundown of the special provisions from Health and Human Services (special provisions are the narrative that go along with the line items) and Education. A summary of Justice and Public Safety and relevant provisions from any other budget subcommittee will be posted later. Appropriations subcommittees will be meeting next week to consider amendments and vote on the proposals.

Health and Human Services Special Provisions

Mental Health Changes: leaves $29 mil in for local inpatient psychiatric beds; $5.7 mil to support 30 mobile crisis teams
MH/DD/SAS Healthcare Information System Project: DHHS may use funds to continue to develop and implement a health care information system for state institutions operated by the Division of MH/DD/SAS.
MH/DD/SAS Community Services funds: Big cuts, prohibition on state funded services for all Medicaid recipients (not just CAP-MR/DD) and copayments for state funded services: $20 mil cut to community service funding; LMEs prohibited from using community services (i.e., state or IPRS) funds for any Medicaid recipients' services, except for residential support services; and Division must develop a set of standardized covered benefits for recipients of state funds; copayment for all mh/dd/sa services based on medicaid copayment rates; reduce the funding for community services funds by additional $25 mil to be allocated among LMEs based on their fund balances ($209 mil in fund balances)
Consolidation of Forensice Health Care at Dix: RFP to consolidate forensic hospital care on the Dix campus.
DHHS Position Eliminations: eliminate 250 FTE positions, or $6.5 mil in state funds
Study DHHS Regulatory Functions: Directs DHHS to study all regulatory functions performed by each division, with recommendations by January 30, 2012. DHHS is directed to develop a plan but not implement or consolidate except as directed by the legislature.
Reduce funding for nonprofit organizations: $5 mil reduction with instruction to minimize 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
Authorizes DMA to take certain steps to make budget reductions: PCS provisions appears to be the same as last year (pages 56-59); MH Residential section (pages 61-62) incorporates changes from HB 377, supported by Disability Rights NC; Change to medicaid rate reductions section - adds adult care homes services to list of services protected from cuts (others are federally qualified health clinics, rural health centers, state institutions, hospital outpatient and pharmacies)
Medicaid Appeals: Unfortunately, it is still not clear what changes are being proposed to the Medicaid appeals process. There are 2 versions included in the Special Provisions starting at page 75 and we have not been able to sort out which version is actually being proposed. So stay tuned.

Education
The Special Provisions are posted here and more handouts from the subcommittee meetings this week are available through the links here.

The proposed Special Provision to accompany the $1 mil proposed allocation to study education reform in NC starts on page 2. Included in the items to study is reducing the teacher:student ratio to 1:15 in first through third grade and transition from high school.
The Special Provision regarding funding for students with disabilities has not changed. This is a relief as this was an option discussed in committee.
A Special Provision starting on page 21 removes the requirement in statute for school improvement and safe school plans.
In the community college section, waiver of tuition and fees will no longer be included for the following: clients of sheltered workshops, clients of adult developmental activity programs, students in Health and Human Services development programs, and juveniles committed to the Department of Juvenile Justice, or prison inmates (although the Community Colleges shall transfer funds to the Department of Correction for curriculum and continuing education instruction, projected to result in a 43% reduction in the number of courses provided to prisoners).

House Appropriations Subcommittee Recommendations

2011-04-12T21:17:00.000-04:00

The House Appropriations subcommittees began unveiling their proposals today. Links and brief summaries for Health and Human Services and Education, as they may relate to people with disabilities, are below. More information on special provisions and other budget subcommittee proposals will be forthcoming.

Health and Human Services - budget documents here - 10% Reduction overall. We have not seen the special provisions.

Governor's Items not included in the House HHS proposals: Cuts that the subcommittee proposes NOT taking: school nurse funds; reduction of local health department funds; teen pregnancy prevention; modify optional and mandatory services for liver, lung, pancreas, small bowel transplants; More at Four swap for TANF; Increases the subcommittee declined to include: NC FAST, Project CARE, Adoption Assistance & Foster Care; and the Mental Health Trust Fund earmark.
Proposed Reductions Highlights:

Division of Central Management and Support

Reduce non-profit funding by $5 mil (2% reduction)
Reduce Community Health Grants by $1.5 mil (23% reduction)
Eliminate Migrant Fee for Service Program by $736K (25% reduction (leaves money in grants))
Eliminate NC Care-Line ($380,478)

Division of Aging and Adult Services

"Prioritize" Senior Center funding - reduction of $660K, 47% reduction
Reduce Home and Community Care Block grant by 12% - $4 mil reduction

Division of Child Development

Reduce Smart Start by 20% ($37.6 mil reduction)
More at Four transfer from DPI
Swap TEACCH General Funds with block grant funds - savings of $3.8 mil.

Division of Social Services

Eliminate Special Adoption vendor payments - $551K
Eliminate Child and Family Team Pilot - $421K
Eliminate Special Assistance Intervention Team - $104K, 2 positions
"Prioritize" Adult Day Care funding - $1.1 mil reduction

Division of Medical Assistance (Medicaid)

Medicaid Provider Assessments ($60 mil reduction)
Targeted Rate adjustments ($6.2 mil), Adjust provider rates ($50 mil), eliminate inflationary increases ($63 mil)
Enhanced Federal Funding for Health Homes (Save $16 mil in first year and $25 mil in second)
Restructure/strengthen Program Integrity ($16 mil reduction and cut 30 positions)
Modify Pharmacy Services ($16 mil)
Modify optional and mandatory services - optical, durable medical equipment, specialized therapies, home health, and modifying a "variety of services" - we need to see the special provisions before we know exactly what is being proposed for each of these
Implement the behavioral health 1915 b/c waiver ($3.2 mil savings in first year, $38 mil saving second year)
$80 mil savings from CCNC
Health Choice targeted rate adjustments ($225K), modify services ($650K) and care coordination ($4 mil)

Division of Services for the Blind, Deaf & Hard of Hearing

Consolidate divisions with Vocational Rehabilitation

Division of MH/DD/SAS

Eliminate Child and Family Support team funding ($523k)
Reduce LME Administration funds by $10 mil in first year and $20 mil in second year (17%)
Eliminate 7 Advocacy positions ($158K, 5% reduction) - I assume this is the Internal Advocacy positions at the facilities
Eliminate Community Funding spent for Medicaid recipients except for residential supports - $20 mil
Swap Fund Balance w/ state service funds - $25 mil
Reduce Division management flexibility funds by $7 mil

Division of Vocational Rehabilitation Services

Reduce Indpendent Living program by $2.5 mil, 13%
Reduce Basic Support Program by $2 mil, 10%

Education - budget documents here: $1.25 billion in proposed cuts to colleges and K-12, 8.8% cut to public schools, 10% cut to community colleges, 15.5% cut to universities

Public Schools

Proposes funding teacher assistants only for K-1 ($259 mil.)
Proposes $1 mil for an education reform study
Reduce at-risk student services by $30 mil
Reduce funding for noninstructional support personnel by $59 mil
Reduce central office administration by $10.7 mil
Reduce funding for principals and assistant principals by $25 mil
Eliminate funding for staff development ($12.6 mil)
More at Four - $16 mil cut with remaining general and lottery funds to Div of Child Development, HHS
Many cuts to the Department of Public Instruction, including a $1.7 mil reduction to the Residential Schools for the Deaf and Blind

Bill Update for the Week of April 4

2011-04-10T14:10:00.000-04:00

HB 329, Bldg Codes/Expand Equine Exemption (Horn, Dixon, Faircloth, Burr Sponsors). HB 329 seeks to exempt from the building code farm buildings used for certain temporary spectator events. The bill was again amended and voted on in the House last week. The building code exemption proposed is now further narrowed to exempt farm buildings used for a spectator event for 50 or more people only if a permit is issued by the fire marshal (which can only be issued if the event is not more than 4 times per year (up to 24 hours each time), outstanding unsafe conditions have been mitigated and a fire watch established). The bill will next be heard in the Senate Agriculture Committee.

HB 351, Restore Confidence in Government (Lewis, Moore and Killian Sponsors). HB351, aka the “Voter ID” bill seeks to require photo identification before voting. The week of March 28 a version of the bill with an expanded list of acceptable identification was discussed in committee. However, this past week, a version much more like the original was proposed and voted upon favorably by the House Elections Committee. This latest version did retain the exception for voters with disabilities, although it removes the language regarding the judgment of the election official: “any voter with a disability who does not present photo identification shall be permitted to vote as provided in this subsection. To satisfy the requirement of this subsection, a person who is at least 18 years of age accompanying the voter with a disability shall execute an affidavit, in the form prescribed by the State Board, affirming under the penalties of perjury that the voter with a disability is the same individual as is registered to vote and, to the best of the affiant's knowledge, does not have the required photo identification. Upon the completion of the affidavit, the voter with a disability shall vote a ballot as if that voter with a disability met the photo identification requirement.” The bill now proceeds to the House Appropriations Committee.

SB 8, No Cap on Number of Charter Schools (Stevens sponsor). This bill eliminates the existing cap of 100 charter schools and makes a number of changes to the existing statute governing charter schools. SB 8 received a favorable report from House Finance and passed 2^nd Reading in the full House. 3d reading is scheduled for Monday evening.

SB 316, Additional Section 1915 Medicaid Waiver Sites (Hartsell Sponsor). SB 316 authorizes DHHS to allow additional 1915 (b)/(c) Medicaid waiver sites and to allow third-party billing for state facilities. This would allow further expansion of 1915(b)/(c) waivers beyond PBH, Mecklenburg and Western Highlands, without legislative approval. After several delays, the bill was heard in the full Senate this week. Senator Nesbitt sought to amend the bill on Thursday to limit the expansion to three additional LMEs but to allow the expansion of PBH to certain additional counties. The amendment failed 20-30. The bill was passed on 3d reading with a 38-12 vote. It will now proceed to the House.

SB 384, Conforming Changes/Persons with Disabilities Act (Hartsell). This is a Disability Rights NC agenda bill. It seeks to amend the North Carolina Persons with Disabilities Protection Act to conform to the Americans with Disabilities Amendments Act of 2008. The bill has successfully passed the Senate and has been referered to the House Judiciary A Committee.

Newly Filed Bills:

The House bill introduction deadline was this week so hundreds of bills were filed in the House. I have tried to catch all the bills relevant to work of Disability Rights NC or of general interest to people with disabilities. Because of the volume, the summaries below are brief.

HB 584, Governor’s Budget (Gillespie, Barnhart, Brubaker, Johnson Sponsors) (SB 500 (Brunstetter, Hunt, Stevens Sponsors) was also filed in the Senate). HB 584 and SB 500 were filed as budget placeholders meant to signify the budget put forth by the Governor. However, a number of provisions in the bills were not discussed earlier when the Governor’s budget was released, e.g., there is a proposal to amend the Medicaid appeals process for recipients that was not in the governor’s original proposed budget. Each was referred to its respective Appropriations Committee.

HB 587, North Carolina Jobs Bill (Bradley, Warren, Torbett, Hastings Sponsors). HB 587 seeks to amend Chapter 150B to further restrict rules that may be promulgated in NC. It has been referred to the House Commerce Committee.

HB 590, Amend Interpreter Laws/Cued Speech (Alexander Sponsor). HB 590 seeks to make clarifying changes regarding cued speech in the laws regulating the practice of interpreters and transliterators. It has been referred to the House Education Committee.

HB 595, Reorganization/Legislative Oversight Comns (Barnhart, Burr Sponsors). HB 595 proposes a new structure for the numerous legislative committees and commissions, including establishing a Joint Legislative Oversight Committee on Health and Human Services, which merges the Study Commission on Aging, the Joint Legislative Health Care Oversight Committee, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, and the Public Health Study Commission. It has been referred to the House Rules Committee.

HB 599, Patient’s Right/Notice of Professional Liability Insurance (Insko, Farmer‑Butterfield, Harrison Sponsors). HB 599 would give adult care home and nursing home residents the right to receive written notice of the facility’s professional liability insurance coverage and to require adult care homes and nursing homes to post information about their professional liability insurance. It has been referred to the House Health and Human Services Committee.

HB 606, Sheriff/Inspect Prescription Drug Records (McElraft, Randleman, McLawhorn Sponsors). HB 606 provides that a sheriff or a designated deputy sheriff investigating the diversion and illegal use of controlled substances may inspect prescription and pharmaceutical records and may also obtain data in the controlled substance reporting system maintained by the Department of Health and Human Services. It has been referred to the House Judiciary B subcommittee.

HB 612, Incapacity to Proceed/LRC Study (Randleman, Hurley Sponsors). HB seeks to authorize the Legislative Research Commission to study the current criminal and mental health laws and procedures regarding incapacity to proceed to trial and involuntary commitment. It has been referred to the House Rules committee.

HB 614, DMA Post Public Notices of Change on Website (Murry, Dollar, Brisson Sponsors). HB 614 seeks to require the Department of Health and Human Services to publish on its web site public notices of changes in statewide methods and standards for setting medicaid payment rates. It has been referred to the House Health and Human Services committee.

HB 618, Streamline Oversight/DHHS Service Providers (Lewis, Hurley sponsors) (SB 525 (Tucker, Hartsell Sponsors) was also filed). HB 618 seeks to streamline duplicate oversight of DHHS service providers by 1) establishing a task force made up of division staff and providers to objectively compare the tools and checklists currently in place, to look for redundancies and review items as to service provider monitoring that are not value added by August 1, 2011, with any duplication identified being removed and streamlines by December 31, 2011. 2) Create one regulatory body within DHHS responsible for oversight review for service providers across all DHHS divisions to reduce duplication by May 1, 2012 and which will allow for one streamlined annual review of service provider agencies by the team of the facility, compliance to rules, record assurances, clinical integrity, and staff training. The Secretary shall also eliminate endorsement and all tools and checklists associated with Local Management Entity monitoring and oversight and replace with service licensure at an agency level, as opposed to a site-specific service license, that the multidisciplinary team issues. 3) Establish a coordination plan for the investigation of abuse or neglect complaints involving multiple agencies. It also seeks to remove the annual Medicaid re-enrollment requirement for providers; mandate a fiscal note for every change or adjustment in service definition, policy, rule, or statute upon enactment; allow for data sharing from the Incident Response Improvement System (IRIS) with service providers and the regulatory body by June 30, 2012; evaluate NC-TOPPS to improve the way data is accessible across services rather than site-specific to reflect valid comparisons of program outcomes by August 1, 2011; and allow private sector development and implementation of an Internet‑based, secure, and consolidated data warehouse and archive for maintaining corporate, fiscal, and administrative records of providers by September 1, 2011. It has been referred to the House Health and Human Services committee.

HB 622, Study Art. 3A Administrative Hearings Proced (McCormick, Stevens, Cleveland, Glazier Sponsors). HB 622 directs the Joint Legislative Administrative Procedure Oversight Committee to study how to reconcile and harmonize administrative hearings in contested cases arising under article 3a of chapter 150b of the general statutes. It has been referred to the House Rules Committee.

HB 623, Eliminate Agency Final Decision Authority (McCormick, Stevens, Cleveland, Glazier Sponsors). HB 623 would remove final decision making authority from agencies in contested cases under Chapter 150B. It has been referred to the House Judiciary A subcommittee.

HB 625, Bill of Rights/Deaf/Hearing Impaired (Blackwell, Farmer-Butterfield Sponsors). HB 625 seeks to create a Deaf Child’s Bill of Rights that will mandate that an IEP team consider a child’s individual communication needs. It has been referred to the House Judiciary A subcommittee.

HB 630, Clarify Law/Older Adults and Long-Term Services (Guice, McGrady Sponsors). HB 630 seeks to update and clarify the statutes in older adults and long-term services and supports, including clarifying that each county, through its county board of commissioners, may elect to establish its own Community Resource Connections for Aging and Disabilities or participate in a multicounty Community Resource Connections for Aging and Disabilities. It has been referred to the House Health and Human Services committee.

HB 632, Juvenile Age to 18 (Lewis, Randleman, Avila, Bordsen Sponsors) (SB 506 (Hartsell, Bingham, McKissick Sponsors) was also filed). HB 632, also known as “Raise the Age,” seeks to amend the definition of “delinquent juvenile” to raise the age from sixteen to eighteen years in six‑month increments of age over a 4‑year period, to provide that 16 and 17‑year‑olds who have been previously convicted of a felony in adult court shall remain in adult court, to provide that 16‑ and 17‑year‑olds alleged delinquent for a class A‑E felony shall be transferred to adult court, to make conforming changes to other statutes relevant to changing the definition of delinquent juvenile, and to extend the Youth Accountability Task Force. It has been referred to the House Judiciary B subcommittee.

HB 659, Capital Procedure/Severe Mental Disability (Stevens, Glazier, McGrady, Harrison Sponsors). This a Disability Rights NC agenda bill. It seeks to amend the capital trial, sentencing and postconviction procedures for a person with a severe mental disability to address the issue upfront in trial, and to remove the death penalty as possible punishment if the individuals qualifies as a person with severe mental disability under the law. It also seeks to provide that Not Guilty by Reason of Insanity is not an available defense if prior alcohol or drug use are the sole cause of the psychosis. It has been referred to the House Judiciary B subcommittee.

HB 677, Discharge of Adult Care Home Residents (Lewis). HB 677 seeks to change the law governing Adult Care Home transfer and discharge of residents to make it easier to do so, to make county Departments of Social Services responsible for placing certain discharged residents, and to enact appeal rights for Adult Care Home residents and Adult Care Homes with respect to discharge decisions. It has been referred to the House Health and Human Services committee.

HB 678, Pilot Release of Inmates to Adult Care Homes (Lewis Sponsor). HB 678 seeks to establish a pilot program to allow certain inmates released from confinement to be placed in Adult Care Homes to receive Personal Care Services and Medication Management. It has been referred to the House Health and Human Services committee.

HB 695, Family/School/Community Compacts (Bell, Lucas sponsors). HB 695 seeks to provide for a family-school compact for every student, which is a written agreement between teachers and parents that clarifies what families and schools can do to help students reach high academic standards. It has been referred to the House Education committee.

HB 709, Protect and Put NC Back to Work (Folwell, Dollar, Hager, Crawford Sponsors) (SB 544 (Brown, Apodaca, Davis Sponsors) was also filed in the Senate). HB 709 seeks to reform the Workers’ Compensation Act. It has been referred to the House Commerce Committee.

HB 721, Landlord/Tenant Bed Bug Liability (McCormick). HB 721 seeks to set out certain obligations of landlords and tenants regarding bedbug infestations. It has been referred to the House Commerce Committee.

HB 734, Require Photo ID/Food Stamps Program (Warren, Brown, Lewis, Moore Sponsors). HB 734 seeks to require DHHS to issue debit cards that contain photo identification on the care for participants in the Supplemental Food and Nutrition Program (SNAP). It has been referred to the House Judiciary C subcommittee, and, if favorable, to Finance.

HB 736, Amend Law re: School Discipline (Langdon, Luebke, Daughtry, Lucas Sponsors). HB 736 seeks to make a number of changes to Chapter 115C regarding school discipline with the goal of keeping students in school. It is a consensus bill supported by Disability Rights NC that numerous entities representing schools and students contributed to. It has been referred to the House Education committee.

HB 745, Study Human Relations Comm Duties (Floyd). HB 745 seeks a Joint Resolution authorizing the Legislative Research Commission to study the duties and services of the NC Human Relations Commission and the Civil Rights Division of the Office of Administrative Hearings. It has been referred to the House Rules Committee.

HB 768, APA Rules: Federal Rule Restriction Ceiling (West, McElraft Sponsors). HB 768 seeks to limit new agency rules to a standard no more restrictive than those imposed by federal law unless required by a serious and unforeseen threat to the public health, safety, or welfare; an act of the General Assembly or United States Congress that expressly requires the agency to adopt rules; change in federal or State budgetary policy; federal regulation; or a court order. It has been referred to the House Environment Committee, and, if favorable, to the Judiciary committee.

HB 770, Reduce & Prevent School Discipline Problems (Cotham, Brandon, Glazier Sponsors). HB 770 seeks to encourage local school boards to adopt policies to prevent disruptive behaviors that lead to suspension and expulsion and thereby to reduce suspension and expulsion rates and to provide alternative learning programs for continued academic progress for students who have been suspended. It has been referred to the House Education committee.

HB 781, Summary Ejectment/Appeals (LaRoque). HB 781 seeks to shorten the time to appeal a magistrate’s judgment in a summary ejectment (eviction) proceeding to 5 days. It has been referred to the House Commerce committee.

HB 793, Full-Service Community Schools Pilot Program (Cotham, Brandon, Jackson Sponsors). HB 793 seeks to establish a full-service community schools pilot program in at least five middle or high schools. The purpose of a full-service community school is to encourage the coordination of academic, social, and health services among schools, community‑based organizations, nonprofit organizations, and other public and private agencies to provide comprehensive academic, social, and health services for students, students' family members, and community members that will result in improved educational outcomes for children. It has been referred to the House Education committee.

HB 808, Revise Laws on Adult Care Homes (Burr). HB 808 seeks to waive annual inspections of Adult Care Homes that achieve the highest rating, and to develop an informal dispute resolution procedure that allows Adult Care Homes to dispute cited inspection deficiencies. It has been referred to the House Health and Human Services committee.

HB 818, Modify Disabled Vet Property tax Exemption (McElraft). HB 818 seeks to enhance the Disabled Veteran property tax homestead exclusion for combat-related disabled veterans. It has been referred to the House Finance committee.

HB 823, Governance of the Dep’t of Public Instruction (Holloway, Hilton, Brubaker, Blackwell Sponsors). HB 823 seeks to amend the North Carolina Constitution to make the Superintendent of Public Instruction the head of the Department of Public Instruction, to make the State Board of Education an advisory body, and to modify the membership of the State Board of Education. It has been referred to the House Education committee, and, if favorable, to Judiciary and then Finance.

HB 826, Coverage for Treatment of Autism Disorders (Parfitt, Glazier, Keever, Murry Sponsors). HB 826 seeks to require health benefit plans, including the State Health Plan, to provide coverage for treatment of Autism Spectrum disorders. It has been referred to the House Health and Human Services committee, and, if favorable, to Insurance.

HB 829, Streamline Education Planning Responsibility (Cotham, Glazier, Holloway, Blackwell Sponsors). HB 829 directs the State Board of Education to consolidate all plans that affect the school community, including school safety plans, school technology plans, plans for academically or intellectually gifted students, and others. It has been referred to the House Education committee.

HB 848, Establish HHS Oversight Committee (Barnhart). HB 848 seeks to establish the Joint Legislative Oversight Committee on Health and Human Services, which is also contained in HB 595. It has been referred to the House Health and Human Services committee.

HB 853, End Ct. Orders/Est. Local Intake Procedures (Mobley). HB 853 seeks to amend the law to no longer require a Court Order to establish local intake procedures for receiving delinquency and undisciplined complaints under the laws pertaining to undisciplined and delinquent juveniles and authorizing the Department of Juvenile Justice and Delinquency Prevention to monitor county detention centers. It has been referred to the House Judiciary Committee.

HB 855, Personal Learning Plan for Each Child (Brandon). HB 855 seeks to require public schools to provide a Personal Education Plan for every student. It has been referred to the House Education committee.

SB 512, Adult Day Care/Overnight Respite Program (Clary). SB 512 seeks to establish adult day care and overnight respite programs under Chapter 131D. It has been referred to the Senate Health Care Committee.

SB 528, Accessible Electronic Info Act/Blind/Disabled (Purcell). SB 528 seeks to establish and maintain an accessible electronic information service for Blind and disabled persons and to appropriate funds for the service. It has been referred to the Senate Health Care committee, and, if favorable, to Appropriations.

SB 535, APA: Modify Final Administrative Decisions (Hartsell). SB 535 seeks to modify the procedures concerning final administrative decisions in contested cases heard by the Office of Administrative Hearings. It has not yet been referred to a committee.

Bill Update for the Week of March 28

2011-04-04T10:29:00.000-04:00

Bills Previously Filed with Action Last Week:

The pace continues to be brisk down at the General Assembly. Legislation is moving quickly and we may be seeing Appropriation subcommittee budget recommendations by the end of the week. Here's the scoop on bills we are tracking:

HB 115, North Carolina Health Benefit Exchange Act (Dockham, Brubaker, Wray, Murry Sponsors). HB 115 seeks to establish a Health Benefit Exchange to make available qualified health benefit plans beginning in 2014. Under the Affordable Care Act, states must either create their own state exchange or opt in to the federal exchange. A Proposed Committee Substitute that still has insurers overseeing the exchange and even goes so far as to charge individuals accessing the exchange a "user fee," received a favorable report in the House Health and Human Services Committee this week. It now goes to the House Insurance committee. For more information about why Disability Rights NC and other advocacy groups oppose this legislation, see the Citizens for Responsible Healthcare website.

HB 234, Juror Qualifications/Disabilities (Glazier, S. Stevens, Parfitt, Samuelson Sponsors). HB 234 seeks to amend the current Juror Qualifications statute to remove the ability to hear as a requirement to serve as a juror. It also seeks to amend the statute regarding Requests to be Excused from Jury Duty to allow potential jurors with a disability to request to be excused if the person feels that their disability could interfere with their ability to serve as a juror. This bill, which was successfully voted on in the House last week was heard in the Senate Judiciary I Committee this week where it received a favorable report. It be voted on by the full Senate on Monday.

HB 351, Restore Confidence in Government (Lewis, Moore and Killian Sponsors). HB351, aka the “Voter ID” bill, in its original form, sought to require photo identification before voting. A new version of the bill released last week but not voted on, adds to the list of acceptable identification a voter registration card with signature verification at the polls; or a current utility bill, bank statement, government check, paycheck, or other government document, also with signature verification. To verify the signature, two election officials will compare the signature with the signature on record, and use their own judgment to decide if the signatures match. There is great concern among voting rights advocates that this procedure could lead to mischief at the polls.
It also proposes a new section pertaining particularly to voters with disabilities:

(a1) Identification Requirement for a Voter with a Disability. – Notwithstanding subsection (a) of this section, if a voter with a disability does not present documentary evidence as required by subsection (a)(1) through (7) of this section, or provides documentary evidence under subsection (a)(8) or (9) but is unable to sign, that person shall still be permitted to vote as provided by this subsection. To satisfy the requirement of this subsection, a person who is at least 18 years of age accompanying the voter shall execute an affidavit, in the form prescribed by the State Board of Elections, affirming under the penalties of perjury that the voter is the same individual as is registered to vote, and to the best of the affiants knowledge either does not have the required documentary identification or is unable to sign to meet the signature verification requirement. As used in this subsection, a "voter with a disability" is a registered voter who, to the satisfaction of the election official who personally sees the voter, on account of the condition of the voter either is unlikely to have any of the documentary evidence or is likely unable to be able to make a signature to meet the signature verification requirement. Such voter shall vote a ballot is if that voter met the documentary identification requirement.

This provision also leaves a great deal in the judgment of the election official.

SB 22, APA Rules: Increasing Costs Prohibition (Brown, Rouzer sponsors). SB 22 seeks to limit new agency rules by amending GS 150B-19 to add that an agency may not adopt a rule that results in additional costs on persons subject to the rule unless the rule adoption is required to respond to a serious and unforeseen threat to the public health, safety, or welfare, an act of the General Assembly or United States Congress, a change in federal or State budgetary policy, a federal regulation, or a court order. It was signed by the Governor last week, S.L. 2011-13. It is became effective when signed and applies to rules published in the North Carolina Register by an agency on or after that date. It expires July 1, 2012.

SB 32, Hospital Medicaid Assessment/Payment Program (Brunstetter, Clodfelter Sponsors). This bill allows the state to obtain federal matching medicaid funds for hospital assessments. It is a method states may use to draw down additional Medicaid matching funds. It was signed by the Governor last week and is Chaptered Session Law 2011-11. It became effective when signed.

SB 109, Spending Cuts for the Current Fiscal Year (Stevens, R., Brunstetter, Hunt Sponsors). SB 109, filed in response to the Governor’s veto of SB 13, directs the Governor to reduce expenditures in the 2010-11 fiscal year in order to increase General Fund availability for the 2011-2012 fiscal year by $537,740,799 by taking all actions necessary and by identifying funds in non-General Fund accounts for transfer to the General Fund on June 30, 2011. It does not apply to funds available to the Judicial Branch or the Legislative Branch. It was signed by the Governor last week - S.L. 2011-15 - and became effective when signed.

SB 248, Update Archaic Disability Terms (Hartsell Sponsor). SB 248 recommends several changes throughout the statutes regarding appropriate terminology for people with disabilities. It reflects recommendations made by the General Statutes Commission. The bill has passed the Senate and the House and will next be signed into law by the Governor.

SB 316, Additional Section 1915 Medicaid Waiver Sites (Hartsell Sponsor). SB 316 authorizes DHHS to allow additional 1915 (b)/(c) Medicaid waiver sites and to allow third-party billing for state facilities. This would allow further expansion of 1915(b)/(c) waivers beyond PBH, Mecklenburg and Western Highlands, without legislative approval. As reported previously, the bill received a favorable report from the Senate Mental Health Committee the week before last but a floor vote in the Senate continues to be postponed. It is currently scheduled to be voted upon by the full Senate on Tuesday, April 5.

HB 329, Bldg Codes/Expand Equine Exemption (Horn, Dixon, Faircloth, Burr Sponsors). HB 329 seeks to exempt from the building code farm buildings used for a temporary spectator event (defined as 120 hours in a calendar year) where a fire watch is maintained. As reported previously, the bill did receive a favorable report from the House committee but it has been postponed from a full House vote several times. It is currently scheduled to be heard on Tuesday, April 5.

SB 375, Facilitate Statewide Health Info. Exchange (Stein and Brunstetter Sponsors). SB 375 seeks to set up a statewide health information exchange network. The framework proposed is to facilitate the exchange of healthcare information among covered healthcare providers within the confines of HIPAA. It allows individuals the right to opt out if they so choose. The provisions proposed only apply to protected health information disclosed within the Health Information Exchange. The bill received a favorable report in the Senate Health Care Committee last week and it will be voted on in the full Senate on Monday.

SB 384, Conforming Changes/Persons with Disabilities Act (Hartsell). This is a Disability Rights NC agenda bill. It seeks to amend the North Carolina Persons with Disabilities Protection Act to conform to the Americans with Disabilities Amendments Act of 2008. The bill received a favorable report from the Senate Healthcare committee last week, and approved by the full Senate with a 48-0 vote. It will now be heard in the House. The House companion bill, HB 530 (Blackwell, Brisson, Earle, Hurley Sponsors), was also filed this week.

Newly Filed Bills:

A large number of bill were filed late last week, a trend that will continue this week as we approach the bill introduction deadline.

HB 487, Exempt Bd Cert. Beh. Analyst/Psych Practice (Parmon, Graham Sponsors). HB 487 seeks to amend the NC Psychology Practice Act to allow certified behavior analysts and assistant behavior analysts to offer services within the scope of practice authorized by the Behavior Analyst Certification Board, including behavior analysis and therapy. It has been referred to the House Health and Human Services Committee.

HB 493, Landlord Tenant Law Changes (Howard, Blust, Randleman Sponsors). HB 493 seeks to weaken certain rights and protections of tenants. If passed it would: 1. Allow removal/eviction more easily when a tenant dies, potentially denying surviving family from removing property. 2. End waiver defense in eviction cases where Landlord could not accept rent from Tenant and then evict them. 3. Reverses NC appellate case law that knowledge of defects, no repairs and continued demand and acceptance of rent is an unfair trade practice. 4. Requires Tenant to pay undefined alleged damages in order to appeal from small claims to District Court, effectively taking away right to new trial in small claims. 5. Allows private process servers for eviction complaints with little or no requirements for qualifications or consequences for abuse. Disability Rights NC is opposed to this legislation. It has been referred to the House Judiciary Subcommittee A.

HB 509, Exclusions from Licensure: Home Services (Hurley Sponsor). HB 509 seeks to allow people with disabilities who receive MH/DD/SA services to live together as roommates without their home being considered a facility for licensing purposes. Specifically, it excludes from licensure: “A home in which up to three adults, two or more having a disability, co own or co rent a home in which the persons with disabilities are receiving three or more hours of day services in the home or up to 24 hours of residential services in the home. The individuals who have disabilities cannot be required to move if the individuals change services, change service providers, or discontinue services.” Disability Rights NC was part of the workgroup that developed this language, and we support this bill. It has been referred to House Health and Human Services Committee.

HB 540, Remove Adult Care Homes from CON Review (Cook, Dixon, Bradley Sponsors). HB 540 seeks to exempt Adult Care Homes from the Certificate of Need approval process. The Certificate of Need process allows for review and an analysis of need before new facilities may open. Disability Rights NC opposes this bill on the ground that it would only serve to increase facilities in the state, and further divert resources away from the community where people may live more independently. The bill has been referred to the House Health and Human Services committee.

HB 541, CAP-MR/DD Waiver Change/Residential Supports (Hurley Sponsor). HB 541 seeks to direct the Department of Health and Human Services to amend the CAP-MR/DD waiver to expand the type of facilities in which a recipient may receive residential supports. It would allow recipients to receive residential supports in a setting with six or fewer beds; a licensed residential setting with more than six beds if the recipient’s plan of care documents the circumstances that require the recipient to live in such a congregate setting; and also specifies that individuals residing in a licensed group home or adult care home with more than six beds, who were receiving services under the CAP-MR/DD waiver on November 1, 2008, may elect to receive residential supports. Disability Rights NC opposes the bill as written as it would direct resources intended for Home and Community based services into larger congregate settings, which is not the intent of the CAP waiver. It has been referred to the House Health and Human Services committee.

HB 542, Tort Reform for Citizens and Businesses (Rhyne, McComas, Brisson and Crawford Sponsors). HB 542 is the omnibus tort reform bill that has been mentioned in previous posts. HB 542 seeks to protect the makers of any drug, chemical or consumer product from lawsuits if the item was approved by or met regulatory requirements of a state or federal government agency; Allow only 25% of large damage awards intended to punish bad behavior to go to the victim, with the other 75% of a punitive award of more than $100,000 going to a state fund; Cap at $250,000 awards for medical malpractice that caused pain, suffering, disfigurement or other non-economic damages, with an inflation adjustment every three years; and Add protections against medical malpractice lawsuits for adult care homes. For the latest news and updates on tort reform, please refer to the NC Advocates for Justice website at http://www.ncaj.com/. The bill has been referred to the House Committee on Tort Reform, which heard from the public about the bill on Thursday.

HB 554, Residential Building Inspections (House Rules Committee bill). HB 554 seeks to limit the allowable periodic building inspections only when there is reasonable cause to believe that unsafe, unsanitary, or otherwise hazardous or unlawful conditions may exists in a residential building; or as part of a targeted effort to respond to blighted or potentially blighted conditions within a Community Development Block Grant geographic area that has been so designated by the board of commissioners, the Dept. of Commerce, Div. of Community Assistance, or HUD. It has been referred to the House Commerce committee.

HB 572, Accountability for Publicly Funded Nonprofits (Justice, Sager, Stevens, West Sponsors). HB 572 seeks to require nonprofits that receive funds from local, state or federal government to provide financial statements and a copy of its IRS Form 990 to the public. As the IRS Form 990 is already publicly available, it is not likely that this would impose any undue burden on nonprofits (For example, Disability Rights NC’s 990 is available on our website). It has been referred to the House Finance Committee.

HB 574, Distribution of Excise Tax on Title Instruments (Hall, Killian, Moore R., Adams Sponsors). HB 574 seeks to change the distribution of the excise tax to allocate a portion to the NC Housing Trust Fund for affordable housing. This would create a designated revenue stream to the Housing Trust Fund. Currently, all of these funds go to the Parks and Recreation Trust Fund and the Natural Heritage Trust Fund. A Senate companion bill, SB 462 (Mansfield, Gunn, Clary Sponsors) was also filed this week. The House bill was referred to the House Finance Committee and the Senate version was referred to the Senate Finance committee. Disability Rights NC, along with a number of organizations who promote affordable housing, supports this bill.

HB 579, Modify Law re: Corporal Punishment (Alexander, Johnson Sponsors). HB 579 seeks to amend the law related to corporal punishment of children in public schools to restrict corporal punishment only to students whose parent or guardian has stated in writing that corporal punishment may be administered on that student. Parents and guardians shall be given a form to make such an election at the beginning of the school year or when the student first enters the school during the school year. A similar restriction was passed last year to allow parents of students with disabilities to opt out of corporal punishment in school. Since the passage of that legislation, the number of schools districts in North Carolina that continue to allow corporal punishment has dropped to 18. Disability Rights NC is working with Action for Children NC, North Carolina Association for Educators, and other organizations to support this legislation. It has not yet been referred to a committee. SB 498 (Pate, Purcell Sponsors) has also been filed in the Senate.

SB 465, Behavioral Health Management (Hartsell Sponsor). SB 465 seeks to allow LMEs that are operating under Medicaid Managed Care waivers (i.e., 1915(b) or 1915(b)/(c) combo waivers like PBH) to organize under Chapter 131E of the General Statutes, Article 2 governing Public Hospitals. It would allow a behavioral health authority to be created under 131E whenever a county board of commissioners finds and adopts a resolution finding that it is in the interest of the public health and welfare to create a behavioral health authority in order to operate a behavioral health program under a Medicaid 1915 (b)/(c) waiver program. The behavioral health authority shall be created in the same manner as a hospital authority under 131E and subject to the same provisions, except that G.S. 131E 20 [regarding geographic boundaries] does not apply to a behavioral health authority. It is unclear how this would benefit the system as a whole. 131E would allow such an authority to appoint commissioners in a manner different from the 122C requirements of LMEs (for example, without the LME board requirements and the requirements for a CFAC). It has been referred to the Senate Mental Health Committee.

SB 474, Photo ID for Certain Controlled Substances (Apodaca, Hise Sponsors). SB 374 seeks to direct pharmacies to require photo identification prior to dispensing Schedule II Controlled Substances. Schedule II includes a number of drugs for pain relief, as well as any drug that contains amphetamine (like Adderall). It would require the patient to present one of the following valid, unexpired forms of government issued photographic identification: (i) a drivers license, (ii) a special identification card issued under G.S. 20 37.7, (iii) a military identification card, or (iv) a passport. It does not provide for circumstances where an individual may not have such identification, or when the patient is a minor, or unable to pick up their own prescription in person. Although this bill is intended to reduce prescription fraud, it should be noted that there are already numerous state and federal provisions in place to discourage the fraudulent dispensing of Schedule II substances. The bill has been referred to the Senate Judiciary I committee.

SB 479, Testing in the Public Schools (Tillman, Preston, Soucek Sponsors). SB 479 seeks to implement several additional components of the state’s testing of public school students: continued participation in the development of the Common Core State Standards in conjunction with the consortium of other states, including implementing the assessments that the State Board deems most appropriate to assess student achievement on the Common Core State Standards; to the extent funds are made available, the State Board shall plan for and require the administration of the ACT test for all students in the eleventh grade unless the student has already taken a comparable test and scored at or above a level set by the State Board, as well as diagnostic tests in the eighth and tenth grades that align to the ACT test in order to help diagnose student learning and provide for students an indication of whether they are on track to be remediation free at a community college or university; and to the extent funds are made available for this purpose, the State Board shall plan for and require local school administrative units to make available the appropriate WorkKeys tests for all students who complete the second level of vocational/career courses. It has been filed in the Senate but not yet referred to a committee.

SB 482, ALJ Final Decision Authority (Hartsell Sponsor). SB 482 seeks to amend the Administrative Procedures Act to authorize Administrative Law Judges to make final administrative decisions in contested cases. For example, under the current law, the Department of Health and Human Services can set aside the decision of an ALJ in Medicaid recipient appeals (which occurs routinely when the ALJ finds in favor of the recipient). The recipient must then appeal to Superior Court to challenge that decision. Under this bill, the ALJ’s decision would be final. The bill has not yet been referred to a committee.

SB 496, PPACA/Required Fraud and Abuse Provisions (Pate Sponsor). SB 496 seeks to implement additional screening for Medicaid and Health Choice providers, identifying providers of certain types of services as low, moderate or high risk. It also provides for criminal history record checks for certain providers. It has not yet been referred to a committee.

EEOC's formal publication of regulations implementing ADA Amendments Act in today's Federal Register

2011-03-25T14:03:00.000-04:00

The Effective date of the new regulations is May 24, 2011.

HTML: http://www.gpo.gov/fdsys/pkg/FR-2011-03-25/html/2011-6056.htm
PDF: http://www.gpo.gov/fdsys/pkg/FR-2011-03-25/pdf/2011-6056.pdf (40 pages)

EEOC also released several guidance documents:

Text of the ADAAA

EEOC's Notice Concerning The Americans With Disabilities Act (ADA) Amendments Act of 2008

Final Regulations Implementing the ADAAA

Questions and Answers on the Final Rule Implementing the ADA Amendments Act of 2008

Questions and Answers for Small Businesses: The Final Rule Implementing the ADA Amendments Act of 2008

Fact Sheet on the EEOC’s Final Regulations Implementing the ADAAA

Bill Update for the Week of March 21

2011-03-25T12:21:00.000-04:00

Bills Previously Filed with Action Last Week:

HB 234, Juror Qualifications/Disabilities (Glazier, S. Stevens, Parfitt, Samuelson Sponsors). HB 234 seeks to amend the current Juror Qualifications statute to remove the ability to hear as a requirement to serve as a juror. It also seeks to amend the statute regarding Requests to be Excused from Jury Duty to allow potential jurors with a disability to request to be excused if the person feels that their disability could interfere with their ability to serve as a juror. Disability Rights NC is working with the sponsors to support the bill. As reported last week, the bill was heard in the House on Thursday, March 17 and while there were still some who spoke against the bill on the ground that it should be allowable to exclude people who are deaf from a jury pool, most of the opposition appeared to be to an amendment lowering the age at which potential jurors can request to be excused based on age. For this reason, the final vote on the bill was not held until Tuesday of this week. On Tuesday, the bill was amended in an 88-30 vote to remove the change in age (which was irrelevant to the original purpose of the bill). At that point, Representative Randleman very eloquently spoke in support of the bill, stating that it simply makes the law consistent with what is already current practice. The bill passed 106-12. It now proceeds to the Senate, where it has been referred to the Senate Judiciary I Committee.

HB 329, Bldg Codes/Expand Equine Exemption (Horn, Dixon, Faircloth, Burr Sponsors). As originally filed, this bill sought to exempt from the building code farm buildings used for a spectator event with more than 10 members of the public present at the event. As the building code requires certain accessibility provisions, in addition to safety, etc., the bill raised concerns for Disability Rights NC. A Proposed Committee Substitute for the bill was presented in the House Committee on Agriculture this week. The new version narrows the exception to farm buildings used for temporary (defined as 120 hours in a calendar year) events where a fire watch is maintained. The new version received a favorable report from the committee but more changes may be made to the bill as it proceeds. The bill will next be heard in the full House.

SB 33, Medical Liability Reforms and Tort Reform Update (Rucho, Apodaca, Brown sponsors). SB 33 seeks to limit medical liability claims through several reforms including a higher standard for liability when providing emergency medical care, ordering bifurcation upon motion of any party, and limiting the amount of noneconomic damages that may be awarded to $500,000 for each plaintiff. The bill was approved by the Senate and is now being considered in the House Select Committee on Tort Reform. A bill draft of comprehensive Tort Reform legislation was presented in the House Select Committee on Tort Reform this past week. It proposed lowering the cap on non-economic damages down to $250,000 (as originally proposed in SB 33), limiting liability for drug manufacturers as long as their product had been approved by the appropriate government regulators, and limiting the amount of punitive damages that can be awarded to a plaintiff to 25% of the punitive awarded with the remaining 75% going to a fund for education, among several other proposals.

SB 316, Additional Section 1915 Medicaid Waiver Sites (Hartsell Sponsor). SB 316 authorizes DHHS to allow additional 1915 (b)/(c) Medicaid waiver sites and to allow third-party billing for state facilities. This would allow further expansion of 1915(b)/(c) waivers beyond PBH, Mecklenburg and Western Highlands, without legislative approval. The bill was heard in the Senate Mental Health Committee this week. During the committee discussion, it was acknowledged that many object to the inclusion of the 1915(c) (a Home and Community Based Supports waiver for people with developmental disabilities) in the managed care model. However, the bill received a favorable report. It will be heard on the Senate floor next week. A house version, HB424 (Barnhart, Ingle and Insko sponsors) was also filed this week and referred to the House Committee on Health and Human Services. As we have previously expressed, Disability Rights NC remains concerned about the expansion of the use of the 1915(b)/(c) waivers on numerous grounds. There are also many questions about how the state will proceed with LME mergers, and, in turn, what entities will be operating the 1915(b)/(c) waivers.

Newly Filed Bills:

HB 417, Extend Time for Site of Low/Moderate Income Housing (McGrady Sponsor). HB 417 seeks to extend the time, for tax purposes, that real property may be held by a non-profit organization as a future site for housing for individuals or families with low or moderate incomes from 5 to 10 years. It was filed on March 21 in the House and referred to the House Commerce Committee.

HB 423, Enact First Evaluation Program (Hurley Sponsor). HB 423 seeks to codify a practice that has been piloted that allows the Secretary to waive the requirements for a physician or eligible psychologist to perform the initial examination for involuntary commitment and substitute a licensed clinical social worker, a master's level psychiatric nurse, or a master's level certified clinical addictions specialist at the request of an LME. When making and considering the request, certain criteria must be addressed. The proposed statutory language also specifies that the waiver shall be for 3 years and the LME shall assure that a physician is available at all times to provide backup support to include telephone consultation and face to face evaluation, if necessary. It was filed in the House on March 22 and referred to the House Health and Human Services Committee.

HB 466, Spend 65% of Funds in the Classroom (Blust). HB 466 seeks to add a new section to Chapter 115C “to ensure that sixty five percent of State funds for the operations of the public schools are used for classroom instruction.” It directs the State Board of Education to modify its allotment formulas, modify its rules regarding the expenditure of State funds, and transfer funds, as necessary, to ensure that each local administrative unit spends on classroom instruction at least sixty five percent (65%) of the State funding it receives for the operations of the public schools. It is not clear how “classroom instruction” would be defined. It has not yet been referred to a committee.

HB 467, Improve School Discipline (Blust Sponsor). HB 467 seeks to amend the current law related to the use of reasonable force in schools to allow reasonable force to be used for discipline purposes and to make it even more difficult to hold school personnel liable for excessive force. The bill proposes a “Teacher Protection Act” “to deter meritless lawsuits and sanction deliberately false reports against educators.” Disability Rights NC is opposed to this bill. It has been filed in the House but not yet referred to a committee.

HB 474, Protect Adult Care Home Residents (Weiss, Hollo, Farmer-Butterfield, Earle Sponsors). HB 474 proposes changes to Chapter 131D governing adult care homes to increase minimum continuing education, training, competency evaluation and inspection requirements for Adult Care Home medication aides, related to Infection Control Requirements. It has been filed in the House but not yet referred to a committee.

SB 384, Conforming Changes/Persons with Disabilities Act (Hartsell). This is a Disability Rights NC agenda bill. It seeks to amend the North Carolina Persons with Disabilities Protection Act to conform to the Americans with Disabilities Amendments Act of 2008. The bill was filed in the Senate last week and will be heard in the Senate Healthcare committee next week – Wednesday at 11 am.

SB 394, Clarify Process/Reportable Offenses in Schools (Newton, Tillman, Preston Sponsors). SB 394 seeks to amend the statute (115C-288(g)) regarding principal reporting of certain acts to law enforcement. It proposes to change the standard from a principal’s “personal knowledge or actual notice from school personnel” to “reasonable belief” (which is further defined) that a specified act has occurred on school property. It also provides that the State Board of Education shall not require the principal to report to law enforcements acts in addition to those required in the statute. It was filed in the Senate on March 22 and referred to the Senate Judiciary I committee.

Bill Update for Week of the March 14

2011-03-19T18:46:00.000-04:00

Bills Previously Filed with Action Last Week:

SB 8, No Cap on Number of Charter Schools (Stevens sponsor). This bill eliminates the existing cap of 100 charter schools and makes a number of changes to the existing statute governing charter schools. A new Proposed Committee Substitute was heard in House Education this week and received a favorable report. This version of the bill again makes changes to the proposed charter schools commission and allows the State Board to veto decisions of the commission by a two-thirds vote. It now also requires that a school's application include a school's plans for providing transportation and food services, also stating that, for each, the school shall make efforts to ensure that it is not a barrier to any student from a household with income below 185% of the poverty level and within within 3 miles, in the case of transportation. The bill will now proceed to House Finance.

SB 22, APA Rules: Increasing Costs Prohibition (Brown, Rouzer sponsors). SB 22 seeks to limit new agency rules by amending GS 150B-19 to add that an agency may not adopt a rule that results in additional costs on persons subject to the rule unless the rule adoption is required to respond to a serious and unforeseen threat to the public health, safety, or welfare, an act of the General Assembly or United States Congress, a change in federal or State budgetary policy, a federal regulation, or a court order. Last week, the Senate concurred in the House Committee Substitute and ratified. It now goes to the Governor.

SB 248, Update Archaic Disability Terms (Hartsell Sponsor). SB 248 recommends several changes throughout the statutes regarding appropriate terminology for people with disabilities. It reflects recommendations made by the General Statutes Commission. SB 248 was heard in the Senate Committee on Healthcare last Wednesday, March 16 and proceeded to the Senate floor where it passed 2d and 3d reading on Thursday, March 17.

Newly Filed Bills:

HB 344, Tax Credits for Children with Disabilities (Stam, Randleman, Jordan and Jones Sponsors). The bill creates an income tax credit for families of children with disabilities who require special education and are attending a nonpublic school or in a public school at which tuition is charged. The credit is equal to the amount the taxpayer paid for tuition and special education and related services expenses, not to exceed three thousand dollars ($3,000) per semester. For home schools, the credit is equal to the amount the taxpayer paid for special education and related services expenses, not to exceed three thousand dollars ($3,000) per semester. It also creates a Fund for Special Education and Related Services, with $2,000 per tax credit given being transferred to the Fund each year. The State Board of Education shall use the revenue in the Fund only for special educational and related services for children with disabilities. HB 344 was filed in the House last week and referred to the House committee on Education, and, if favorable, Finance. Disability Rights NC neither supports nor opposes the bill.

HB 351, Restore Confidence in Government (Lewis, Moore and Killian Sponsors). HB351, aka the “Voter ID” bill, will require photo identification before voting. The bill also makes a number of other changes to the election laws related to campaign finance. The bill was filed Monday night. A public hearing was held on Tuesday afternoon, followed by a committee meeting to discuss the bill. The bill will be discussed in the Election Law committee again next week but it is unclear whether the committee will vote or not. The bill requires voters to present one of seven types of photo identification at polling places in order to vote: a NC drivers license; special identification card from the Division of Motor Vehicles (which will be free under the bill’s proposed changes to anyone eligible to vote who does not have a valid photo identification acceptable under this section); a valid identification card issued by any branch, department, agency or entity of any state in the U.S. authorized by law to issue personal ID; a valid US passport; a valid employee ID card issued by any branch, department, agency or entity of the US, NC, or any county, municipality, board, authority or other entity of this state; a valid US military ID card; a valid tribal ID card; or a valid NC Voter Identification card (a new form of photo ID to be issued by county boards of election). To obtain a Voter ID card, a person must present a photo identity document or a nonphoto identity document if it has the person’s name, evidence that the person is registered to vote in NC, and documentation showing the person’s name and residence address. (Note there is no change to the voter registration application which DOES NOT require photo ID but requires a drivers license number or, if the applicant does not have a drivers license number, the last four digits of the applicant's social security number, and any other information the State Board finds is necessary to enable officials of the county where the person resides to satisfactorily process the application.) The proposed Voter ID card is only valid as long as the person resides at that address and remains qualified to vote – each time a person moves, he/she will have to obtain a new card and surrender the old card. To register and vote at a one-stop site, a voter will have to present photo ID as described above. If a voter is not able to present photo ID, the voter may vote a provisional ballot but will need to come back and provide valid photo ID and execute an affidavit affirming that she voted on election day or at an early voting site. It also adds the voter presenting proof of identification as a reason to challenge another voter; and adds “observer” to the list of officials who may enter challenges against voters. The bill also modifies the requirement for requesting absentee ballots so that the requestor need only sign the ballot and not write the entire request. At the public hearing DRNC discussed barriers that already lead to people with disabilities voting at a rate 10-15% lower than the rest of the population, and our concerns that additional requirements will only further deter voters with disabilities. We also suggested several changes to the legislation including an exemption for eligible voters living in long term care facilities, to allow voters with a valid ID to prove a new address with accompanying documentation to change registration or vote at an Early Voting site, and to allow the ID requirement to be waived if the poll worker can corroborate the voter’s identity. A Senate version, SB 352 (Meredith and Hise Sponsors) was also filed this week.

HB 364, Funds/Project C.A.R.E. (Adams Sponsor). HB 364 seeks funds for the Project Caregiver Alternatives to Running on Empty program. The bill was filed in the House on March 15 and referred to the House Appropriations Committee.

HB 374, Eugenics Records/Public Records Exemption (Womble and Parmon Sponsors). The bill makes clear that records in the custody of the State concerning the North Carolina Eugenics Board program are not public records to the extent they concern: (i) persons impacted by the program, (ii) persons or their guardians or authorized agents inquiring about the impact of the program on them, (iii) persons or their guardians or authorized agents inquiring about the potential impact of the program on others. It also states that a person impacted by the program may obtain that person's individual records under the program, and a guardian or authorized agent of that person may also obtain them. The bill was filed in the House on March 16 and referred to the Judiciary Committee.

HB 377, Strengthening Residential Placement (Brisson Sponsor). HB 377 seeks changes to the budget special provision regarding the restructuring of Level III and IV mental health residential placements to add that an assessment shall be completed to ensure the appropriateness of placement before admission to such a placement; to extend the length of stay to 180 from 120 days (180 is the average length of stay); and to specify that the authorization approval is not conditional upon all signatures and that LMEs shall designate appropriate individuals who can sign the discharge plan within 24 hours of receipt. The bill was filed in the House on March 16 and referred to the House Committee on Health and Human Services.

HB 397, DHHS Penalties and Remedies Revision (DHHS Agency Bill) (Lewis Sponsor). HB 397 seeks to amend facility penalty provisions under 122C, 131D and 131E to split Type A violations into Type A1 (violations that result in death or serious physical harm, abuse, neglect, or exploitation) and Type A2 violations (violations that result in substantial risk that death or serious physical harm, abuse, neglect, or exploitation will occur). When a Type A1 violation is found, the person making the finding shall require a written plan of protection regarding how the facility will immediately abate the Type A1 Violation in order to protect clients from further risk or additional harm; and the Department shall impose civil penalties. A Type A2 violation still requires a written plan of protection but civil penalties are only imposed when the facility fails to correct. It also prohibits a penalty for a past corrected violation (defined as a violation not previously identified by the Department that has been corrected) when the violation or violations were abated immediately; and the facility implemented corrective measures to achieve and maintain compliance. HB 397 was filed on March 16 and referred to the House Judiciary A Committee, and, if favorable, to Finance.

SB 344, Government Transparency Act of 2011 (Clary, Tucker and Goolsby Sponsors). SB 344 would require state agencies and other public entities (including LMEs and counties) to maintain information on employee performance and the reasons for each promotion, demotion, transfer, suspension, separation, or other change in position classification. The bill was filed in the Senate on March 14 and referred to the Senate Judiciary I Committee.

SB 370, Increase Disabled Vet Property Tax Exclusion (Tillman and Soucek Sponsors). The bill seeks to increase the disabled veteran property tax homestead exclusion from $45,000 to $65,000. It has been filed in the Senate but not yet referred to a committee.

SB 375, Facilitate Statewide Health Info. Exchange (Stein and Brunstetter Sponsors). SB 375 seeks to set up a statewide health information exchange network. The framework proposed is to facilitate the exchange of healthcare information among covered healthcare providers within the confines of HIPAA. It allows individuals the right to opt out if they so choose. The provisions proposed only apply to protected health information disclosed within the Health Information Exchange. It has been filed in the Senate but not yet referred to a committee.

Disability Awareness Day March 22d at the NC Legislature

2011-03-14T13:43:00.000-04:00

See the flyer here.

Morning Schedule (in the Auditorium):

10 AM. -10:15 Opening Remarks /Introductions and Logistics

10:15 -10:50 Discovering and Discussing Common Advocacy Goals a.k.a “Building the “We” –facilitated by J. Whalen

10:50—11:00 break

11:00-11:40 Current and Constant Awareness and Policy Challenges—Voices of Success and Frustration—“Open Mic type session”

11:40-11:55 Legislative Talking Points (some issues we all can share with legislators in the afternoon)

11:55--? Lunch (on your own –however 100 or so sandwich/fruit/water combos will be available for first registered/first-served attendees).

Afternoon:

Meet with legislators or continue team building with other advocates

Bill Update for the Week of March 7

2011-03-13T15:11:00.000-04:00

Bills Previously Filed with Action Last Week:

HB 2, Protect Health Care Freedom (Barnhart, Stam, Hollo, Murry sponsors). This bill seeks to prevent the implementation of the Affordable Care Act (i.e., healthcare reform legislation) provision that mandates individual health insurance. It also mandates that the Attorney General shall either join or bring a lawsuit challenging this provision. In last week's update, I reported that the Governor vetoed the bill. The House voted to override the veto last week but fell short. However, due to some parliamentary maneuvering, the House could make another attempt to override the veto this coming week.

SB 8, No Cap on Number of Charter Schools (Stevens sponsor). This bill eliminates the existing cap of 100 charter schools and makes a number of changes to the existing statute governing charter schools. A new Proposed Committee Substitute was heard in House Education last week but not voted upon. Although the language that we remain concerned with regarding discrimination in admissions remain unchanged, a number of other changes were made that continue to take the bill in a positive direction - including a new provision that gradually raises the cap by 50/year, creates a Public Charter School Commission under the State Board of Education (with the majority of the appointees coming from the legislature), and a number of changes to the local funding that will not transfer to the charter schools. It is scheduled to be heard again this Tuesday.

Newly Filed Bills:

HB 247, Enhance Charter School Accountability (Glazier, Cotham, Rapp and Lucas Sponsors). HB 247 was filed this week as the Democrats’ response to SB 8, also lifting the cap on charter schools. It was referred to the House Committee on Education, and then to Finance and Appropriations. As stated above in the update for SB 8, it continues to head in the right direction, so perhaps there will be a meeting of the minds with some of the additional language in HB 247. In particular, Disability Rights NC supports the amendments HB 247 proposes to 115C-238.29F(g)(5) regarding discrimination in the admissions process.

HB 249, Update Archaic Disability Terms (Ross Sponsor). HB 249 recommends several changes throughout the statutes regarding appropriate terminology for people with disabilities. It reflects recommendations made by the General Statutes Commission. It has been referred to the House Judiciary Subcommittee A. SB 248 (Hartsell Sponsor) was also filed in the Senate. SB 248 was referred to the Senate Committe on Health Care where it is scheduled to be heard on Wednesday.

HB 267 and HB 287, Mental Health Workers’ Bill of Rights (Bell Sponsor). Both bills seeks to enact an Artilce 8 in Chater 122C to establish a bill of rights for mental health workers, which includes among other things, the right to protect oneself from harm, to refuse work that poses a danger to one's health and safety, to adequate staffing levels, adequate and updated equipment and techniques to insure safer working conditions and quality care for the patients, and to refuse excessive overtime. HB 267 includes two additional rights that HB 287 does not: the right of workers to evaluate the performance their supervisor as one of the criteria for their raises and ongoing duties; and the right to belong to a union and engage in collective bargaining over terms and conditions of work. HB 267 has been referred to the House Rules committee and HB 287 has been referred to the House HHS committee.

SB 316, Additional Section 1915 Medicaid Waiver Sites (Hartsell Sponsor). SB 316 authorizes DHHS to allow additional 1915 (b)/(c) Medicaid waiver sites and to allow third-party billing for state facilities. This would allow further expansion of 1915(b)/(c) waivers beyond PBH, Mecklenburg and Western Highlands, without legislative approval. It has been filed but not yet referred to a committee. As we have previously expressed, Disability Rights NC remains concerned about the expansion of the use of the 1915(b)/(c) waivers on numerous grounds.

Week of March 7 Budget Update

2011-03-13T08:56:00.000-04:00

HHS Appropriations
Medicaid and Piedmont Behavioral Health
On Tuesday, Craigan Gray and Steve Owen finished up a presentation on Medicaid and Pam Shipman from PBH presented. The Medicaid handout is online here. The PBH presentation is online here. The PBH presentation was not much different from other presentations they have done. Some points that were made that I would like to note:

The slide that states that the PBH model has management of all public resources, including Medicaid funds, state/federal funding and state institution funds, is misleading. PBH only covers behavioral health. Other Medicaid services (primary care, etc.) are covered under the Southern Piedmont Community Care Plan (the local CCNC affiliate).
State funds account for 20% of the PBH budget.
Although the slides related to comparative costs for certain types of services are not clear as to scale, they demonstrate no significant cost differential for ICF-MR, 1915(c) services (Innovations and CAP-MR/DD), and possibly outpatient and inpatient psychiatric care (without further explanation of their numbers it is impossible to know if the difference is statistically significant).

Division of Mental Health and the Division of State Operated Healthcare Facilities
On Wednesday, legislative staff (NOT DHHS staff as was done for Medicaid) presented reduction options related to the Division of Mental Health and the Division of State Operated Healthcare Facilities. Of particular note:

It was stated that the cost of ICF-MRs is mostly medicaid, with only a small amount in the DMH and DMA budgets for state dollars, so there wouldn't be much savings to close the DD Centers.
Total funds spent through the LMEs - $533 mil (state and federal) - $350 mil to community services ($350 mil) and $115 mil in administrative funding (22% of the money allocated to LMEs, $65 mil state and $50 mil federal). Staff discussed the high percentage of administrative costs (according to the Mercer report the national average is 10-15%) and laid out options to consolidate and reduce the number of LMEs. For community services funds, staff suggested standardizing the service package of benefits among LMEs, creating a standard benefits package among LMEs, and instituting a co-payment as reduction options. There were alse questions about the LME fund balances.
Staff put forth closing the Wrights School as an option.
ADATCs – there is not really an option for this, but could see if there is a private market.
Advocacy staff - $3.5 mil in salaries/fringe (both state and federal cost) – 40 positions to serve 15 facilities, 23 throughout communities. In his response, Secretary Cansler pointed out that the advocacy staff is crucial to the facilities, and the amount saved in state dollars would be minimal.
CRH Hospital Administrator Contract – could save $30K by hiring as an employee. Cansler also responded to this point in his response.

Education Appropriation
K-12 Education Reduction Options - handout here. Some options discussed include:

Eliminating $9 mil in support for Child and Family Support Teams
Children with Disabilities Reductions: 2 reductions are discussed: 1) 3.4, 4.2 and 5% reductions to the state allocation for children with disabilities ($23,964,707, $29,042,061, and $34,694707 reductions to $693,894,148). Staff is further investigating this option regarding federal Maintenance of Effort requirements for IDEA funding. These options were not in the Governor's budget. 2) The Governor's budget included a $7 mil reduction in anticipation of a reduced headcount.
Reduce funding for the Residential Schools for the Deaf and Blind by 5 and 10% ($1.6 mil and $3.3 mil out of $32.6 mil budget).
There are also proposals to reduce funding for teacher assistants, local school district central office administration, principal and assistant principals, instructional support (guidance counselors, social workers, etc.), eliminate funding for staff development, retirement incentives for LEAs and to eliminate the More at Four/DPI Office of School Readiness.

Proposed Community College Admission Rule Coming Up at the Rules Review Commission March 17th

2011-03-07T17:39:00.000-05:00

As you may remember from an earlier post, the Community College board proposed a change to its admission policy last September. The proposed language would allow community colleges to adopt policies refusing admission "if it is necessary to protect the health or safety of the applicant or other individuals." The proposed language does not detail how such a determination will be made, nor did it mandate notice and appeal of the decision by the applicant. In response, Disability Rights NC, along with the ACLU of North Carolina, the Arc of North Carolina, the Autism Society of North Carolina, and the National MS Society in NC, filed written comments and commented in person at a public hearing to voice our opposition to the proposed rule amendment.

Unfortunately, the Community College board has proceeded with the rule change. The Community College board did incorporate language directing the Board of trustees to implement an appeals process for applicants denied admission under the new rule. The new language can be seen on the Rules Review Commission website here in the Log of Permanent Rule Filings that will be considered next Thursday, March 17 - look under Community Colleges, Board Of - Admission to Colleges.
When the Rules Review Commission (RRC) takes up the rule at its meeting on March 17th (it is not listed separately on the agenda but is on the Log of Permanent Rule Filings to be considered), it will not consider questions relating to the quality or efficacy of the rule but only determines whether the rule meets all of the following criteria:

(1) It is within the authority delegated to the agency by the General Assembly.

(2) It is clear and unambiguous.

(3) It is reasonably necessary to implement or interpret an enactment of the General Assembly, or of Congress, or a regulation of a federal agency. The Commission shall consider the cumulative effect of all rules adopted by the agency related to the specific purpose for which the rule is proposed.

(4) It was adopted in accordance with Part 2 of this Article (i.e., the agency followed the proper procedures in the Administrative Procedures Act, G.S. 150B-21.2 in this case).

The RRC can either approve or object on these grounds. If they object, it will be sent back to the Board of Community Colleges which has the opportunity to try to adjust the rule to address the RRC’s concerns. Then the rule would go back to RRC.

We have been told that there were already at least 14 objections from the public as of several weeks ago. This means that regardless of whether the RRC approves or objects, the rule is going to be subject to legislative review and the effective date will be postponed. The Administrative Procedure Act says that if the rule is subject to legislative review, the legislature has until the 25th legislative day of the following legislative session to file a bill disapproving the rule which actually means that the General Assembly has until the 25th day of the 2012 session to deal with this. However, the legislature may take it up earlier than that to disapprove the rule if it so chooses. In the meantime, the rule cannot go into effect.

Anyone can provide comments to the RRC or object to the proposed rule. Written or oral comments to the RRC would be most effective if they address the elements listed above. To submit written comments to the RRC, the comments must be submitted to the individual commissioners, the RRC staff (2 copies if in writing and 1 copy if by email), and the agency rulemaking coordinator by 5:00 pm of the Tuesday of the week prior to the RRC meeting - which would be TOMORROW. Contact information for the RRC members can be found here, RRC staff contact information is here and the rulemaking coordinator for the community colleges is Shante Martin, martins@nccommunitycolleges.edu. If you would like to make an oral statement at the RRC meeting, you must notify the RRC staff and the agency rulemaking coordinator in writing by 5:00 pm of the second business day before the RRC meeting - you must identify the rule upon which you are seeking to comment, and include your name, address, telephone number, fax number and email address. If you did not submit a written comment, state whether your oral statement will support or oppose the rule.

Finally, to object to the rule on substantive grounds, you must submit a written objection clearly requesting review by the legislature by 5:00 PM of the day following the day the Commission approves the rule. The Commission will receive those objections by mail, delivery service, hand delivery, or facsimile transmission. If you have any further questions concerning the submission of objections to the Commission, please call a Commission staff attorney at 919-431-3000.

Bill Update for the Week of February 28

2011-03-07T13:38:00.000-05:00

I apologize for getting this out late. Here's an update on newly filed bills and action on bills previously filed from last week.

Bills Previously Filed with Action Last Week:

HB 2, Protect Health Care Freedom (Barnhart, Stam, Hollo, Murry sponsors). This bill seeks to prevent the implementation of the Affordable Care Act (i.e., healthcare reform legislation) provision that mandates individual health insurance. It also mandates that the Attorney General shall either join or bring a lawsuit challenging this provision. The Governor vetoed this bill on Saturday. Stay tuned on whether the legislature will seek an override vote.

SB 8, No Cap on Number of Charter Schools (Stevens sponsor). This bill eliminates the existing cap of 100 charter schools and makes a number of changes to the existing statute governing charter schools. The bill was referred to the House Committee on Education last week, where it is scheduled to be heard tomorrow at 10 am.

SB 22, APA Rules: Increasing Costs Prohibition (Brown, Rouzer sponsors). SB 22 seeks to limit new agency rules by amending GS 150B-19 to add that an agency may not adopt a rule that results in additional costs on persons subject to the rule unless the rule adoption is required to respond to a serious and unforeseen threat to the public health, safety, or welfare, an act of the General Assembly or United States Congress, a change in federal or State budgetary policy, a federal regulation, or a court order. The bill is now in the House and was heard in the House Agriculture/Natural Resources Committee last week. The Proposed Committee Substitute heard and approved in the House committee included language defining "substantial estimated additional costs" and added a sunset of July 1, 2012. There was ample testimony from members of the committee about concerns about this legislation. A former state health director also spoke about his concerns about limiting rulemaking related to public health, safety, or welfare only to serious and unforeseen threats. A letter from administrative law professors raising similar concerns was also mentioned during the committee hearing.

Newly Filed Bills:

HB 223, Health Families & Workplaces/Paid Sick Days (Adams Sponsor). This legislation seeks to ensure that all workers have paid sick days for the own medical needs as well as the health needs of their family members. It was introduced in the House last week and referred to the Committee on Commerce and Job Development.

HB 229, Rural Operating Assistance Program Changes (Owens Sponsor). HB 229 will allow regional public transportation authorities, upon written agreement with the counties, to apply for Elderly and Disabled transportation and assistance funds to which the member counties are entitled to receive. The bill was filed in the House last week and referred to the House Committee on Transportation.

HB 233, Department of Correction/Ex-Offenders (Pierce, Bryant, M. Alexander, Frye Sponsors). This bill was a recommendation of the Joint Select Committee on Ex Offender Reintegration into Society. HB 233 designates the Department of Correction (DOC), Office of Research and Planning (ORP), as the single State agency responsible for the coordination and implementation of ex-offender reentry policy initiatives, including the StreetSafe Task Force, the Justice Reinvestment Initiative of the Council of State Governments (CSG), and the recommendations of the Joint Select Committee on Ex Offender Reintegration into Society. The ORP is also directed to work with local communities to form a minimum of 10 local reentry councils to supervise and coordinate innovative responses to reintegration at the local level and to use the existing services of programs, e.g., the Criminal Justice Partnership Program; and to form an advisory group that represents the population it proposes to serve, including, but not be limited to, the formerly incarcerated, people with criminal records, and at risk youth, as well as agencies that serve all of the above. The bill also directed the DOC to continue its efforts to assist offenders in successfully reentering society and to enable them to avoid further criminal behavior, including monitoring and maximizing the access to the partnerships with the Division of Motor Vehicles regarding identification cards and licenses and the community colleges regarding education and job readiness, and by maximizing work release slots for minimum custody inmates approaching release. The bill was filed in the House on March 3d and has not yet been referred to a Committee. A companion Senate bill, SB 221 (Hartsell, Dannelly, E. Jones Sponsors), was also filed in the Senate. Disability Rights NC followed the committee on Ex-Offender Reintegration and advocated for services for ex-offenders with mental illness in particular.

HB 234, Juror Qualifications/Disabilities (Glazier, S. Stevens, Parfitt, Samuelson Sponsors). HB 234 seeks to amend the current Juror Qualifications statute to remove the ability to hear as a requirement to serve as a juror. It also seeks to amend the statute regarding Requests to be Excused from Jury Duty to allow potential jurors with a disability to request to be excused if the person feels that their disability could interfere with their ability to serve as a juror. Disability Rights NC is working with the sponsors to support the bill. We believe the bill will remove a requirement from the Juror Qualification statute that is illegal under Section 504 of the Rehabilitation Act and the Americans with Disabilities Act. The bill was filed in the House on March 3d and has not yet been referred to a committee.

HB 237, Economic Impact/Regulatory Legislation (Dollar, Rhyne, McElraft, Folwell Sponsors). HB 237 seeks to require economic impact statements on all bills that propose regulatory changes, similar to the fiscal notes that agencies prepare during rulemaking. The bill goes hand-in-hand with SB 22, APA Rules: Increasing Costs Prohibition, which seeks to curtail any state regulations that have a fiscal impact. SB 22 sets a high standard for when regulations may be promulgated for health and safety – it must be an unforeseen threat to the public health, safety, or welfare. The bill was filed in the House on March 3d and has not yet been referred to a committee.

SB 166, No Adult Left Behind (Hartsell). SB 166 seeks to establish a “No Adult Left Behind” initiative led by the Commission on Workforce Development, acting as the lead agency, geared toward achievement of major statewide workforce development goals. The goal of the Initiative is to increase the percentage of North Carolinians who earn associate degrees, other two year educational credentials, and baccalaureate degrees. The bill was filed last week and will be heard in the Senate Committee On Education/Higher Education on Wednesday at 10 am.

SB 167, Expand Capitated Waiver (Hartsell Sponsor), the Senate companion bill to HB 127, (Insko, Barnhart, Alexander Sponsors), allows DHHS to expand the 1915(b)/(c) Medicaid waiver to any additional local management entity catchment area upon demonstrating to the satisfaction of the General Assembly that the expansion (i) is allowable under Medicaid, (ii) will result in savings to the State, and (iii) will provide outcomes equal to or better than those that could be achieved without the proposed expansion. It was filed in the Senate last week and was Referred to the Senate Committee on Health Care.

SB 217, Promote Funding Availability (Hartsell, Dannelly, E. Jones Sponsors). SB 217 is another recommendation of the Joint Select Committee on Ex Offender Reintegration into Society. The bill directs the Governor's Crime Commission of the Department of Crime Control and Public Safety to increase its efforts to promote funding availability to local and nonprofit groups engaged in ex offender reintegration services based on evidence based practices, and shall establish offender reentry as a funding priority. The bill was filed in the Senate last week but has not yet been referred to a committee.

SB 219, OSP/ Hiring of Ex-Offenders (Hartsell, Dannelly, E. Jones, Ed Sponsors). SB 219 directs the Office of State Personnel to develop a protocol for State agencies to collect and track application and hiring rates of ex offenders and to develop proposed policies identifying the specific occupational categories for which a conviction is a bar to employment. The proposed policies shall require that for those occupational categories, the hiring authority may require disclosure of prior conviction on application; however, for all other occupational groups, the proposal shall provide that State hiring authorities shall not, during the hiring process, make an inquiry regarding a conviction on the initial application for employment and shall only take into consideration a conviction after the applicant has been selected as a finalist for that position. The bill has been filed in the Senate but not yet referred to a committee.

Citizens for Responsible Health Care to Hold a Press Conference Tomorrow at Legislature

2011-03-01T13:03:00.000-05:00

MEDIA ADVISORY: New Health Care Coalition calls for pro-consumer Health Insurance Marketplace in North Carolina

Tomorrow, Wednesday March 2, Citizens for Responsible Health Care will outline what a meaningful health benefit exchange should look like – the biggest health care issue in North Carolina’s General Assembly in years.

WHO: Citizens For Responsible Health Care, a 9-group coalition of health care and consumer organizations

WHAT: A press conference

WHEN: Wednesday, March 2, 11 a.m.

WHERE: Outside of the NC legislative building on 16 W. Jones St.
RALEIGH (March 2, 2011) – To improve health care for North Carolinians, the state’s Health Insurance Marketplace must offer real choice that brings down costs for individuals and small businesses – and not simply be a tool of the insurance industry.

With some bills threatening meaningful health care improvements for North Carolina, Citizens For Responsible Health Care will hold a press conference March 2 outlining what a meaningful, pro-consumer marketplace should look like.

North Carolina and other states are required by the Affordable Care Act to create "benefit exchanges" by 2014. These are meant to be online marketplaces where consumers and small business can find affordable plans.

But insurance industry influence threatens to undermine these vital reforms. Tomorrow, the coalition will offer two principles that any meaningful health insurance marketplace must abide by:

1. Real competition and meaningful choice to bring down costs.
2. Credibility and independence – be a tough, independent consumer watchdog.

Members of coalition groups will be available for media comment.
CITIZENS FOR RESPONSIBLE HEALTH CARE MEMBER GROUPS
AARP North Carolina
Action for Children North Carolina
American Cancer Society
Covenant with North Carolina’s Children
Disability Rights North Carolina
Hemophilia of North Carolina
National Multiple Sclerosis Society – North Carolina Chapters
North Carolina Justice Center
North Carolina State AFL-CIO

FOR MORE INFORMATION, CONTACT: Abby Carter Emanuelson, National Multiple Sclerosis Society, 919.792.1006, abby.emanuelson@nmss.org; Adam Searing, Project Director, North Carolina Health Access Coalition, adam@ncjustice.org, (919) 856-2568; Jeff Shaw, Director of Communications, NC Justice Center, jeff@ncjustice.org, 503.551.3615.

Proposed Amendment to CAP-MR/DD Clinical Coverage Policy

2011-02-28T16:01:00.000-05:00

The NC Division of Medical Assistance has posted a proposed amendment to the CAP-MR/DD Clinical Coverage Policy related to the Supports Intensity Scale. The language is below but click here to view the entire proposed policy. Comments may be submitted through the website (click here) by April 10, 2011.

The Proposed Language:
The Supports Intensity Scale™ (SIS) is an assessment tool that, when administered properly, measures an individual’s intensity of need for supports to participate fully in community life. SIS is used in person-centered planning to assist individuals in developing strength based, not deficit based, plans. The 3 sections of the SIS are:
a. Supports Needs Scale;
b. Supplemental Protection and Advocacy Scale; and
c. Exceptional Medical and Behavioral Supports Needs.

The SIS was piloted in seven Local Management Entity (LME) Catchment areas due to legislative mandate that the results of the SIS assessment be used to assign clients with developmental disabilities to one of the tiers within the CAPMR/DD Waiver and to other needed services, according to their relative intensity of need. A technical amendment will be submitted to CMS requiring that the completed SIS be done for individuals in all LME Catchment areas receiving CAP MR/DD funding in order to comply with the legislation and to begin work towards building a funding model to distribute funding based on intensity of need. Beginning with Initial Plans and Continued Need Reviews (CNRs) effective 7/1/11 and after, the SIS will be required to be submitted with the Initial Plan of Care or CNR to the appropriate Utilization Review (UR) Vendor for approval of CAP Waiver Services. Reassessment will occur every three years.

Bill Update for Week of February 21

2011-02-25T16:53:00.000-05:00

Bills Previously Filed with Activity this week (Click on the bill number to link to the General Assembly website for full text and other information about the bill):

HB 2, Protect Health Care Freedom (Barnhart, Stam, Hollo, Murry sponsors). This bill seeks to prevent the implementation of the Affordable Care Act (i.e., healthcare reform legislation) provision that mandates individual health insurance. It also mandates that the Attorney General shall either join or bring a lawsuit challenging this provision. The House concurred with the Senate committee substitute this week. The bill now goes to the Governor. Last Friday, the Governor indicated that she will not veto the legislation. She may be reconsidering that decision in light of a letter from Attorney General Roy Cooper this week highlighting the financial implications to the Medicaid program that could result from the law's enactment. For more coverage of the Attorney General's letter click here.

SB 8, No Cap on Number of Charter Schools (Stevens sponsor). This bill eliminates the existing cap of 100 charter schools and makes a number of changes to the existing statute governing charter schools. The bill passed the Senate Finance committee and a full Senate vote this week. Several amendments were proposed on the floor aimed at ensuring diversity and that charter schools are open to all students. Most failed. One amendment, advocated for by DRNC, was passed to add certain reporting requirements for the charter school commission to report to the Legislative Oversight Committee on Education. The bill does now include language related to students with disabilities in several areas: a charter school's application must include a plan for identifying and successfully serving students with disabilities, among other student groups; nothing in the subsection related to admission requirements shall be interpreted to preclude the formation of a charter school whose mission is focused on serving students with disabilities, among other student groups; and the annual reporting requirements include annual data disaggregated by charter school on the gender, race and ethnicity and disability status of students enrolled in charter schools; testing data disaggregated by the purpose of the charter school, and by gender, race and ethnicity, and disability; the number of students long-term suspended and expelled; the number of students receiving a free and reduced meal plan through a federal subsidy program; the number of students receiving a free and reduced meal plan through means other than a federal subsidy program; and the number of students receiving special education services. The current statute does also state that schools must comply with policies adopted by the State Board of Education for charter schools relating to the education of children with disabilities. However, the statute also includes language that states that schools shall not limit admission to students on the basis of intellectual ability, measures of achievement or aptitude, athletic ability, disability, race, creed, gender, national origin, religion, or ancestry EXCEPT as otherwise provided by law or the mission of the school as set out in the charter. Disability Rights NC believes that this language could be interpreted to allow discimination against students with disabilities in the admissions process. The bill now proceeds to the House, where we will continue to advocate for the removal of this language from the statute.

SB 13, Balance Budget Act of 2011, (Stevens, Brunstetter, Hunt sponsors). SB 13 seeks to reduce the current year's budget by at least $400 million, and directs transfers from various funds. The Governor vetoed this bill this week. The Senate has already filed another bill directing reductions, without specifically directing the transfer from various funds. SB 109, Spending Cuts for the Current Fiscal Year (Stevens, R., Brunstetter, Hunt Sponsors) directs the Governor to reduce expenditures in the 2010-11 fiscal year in order to increase General Fund availability for the 2011 2012 fiscal year by $537,740,799 by taking all actions necessary and by identifying funds in non-General Fund accounts for transfer to the General Fund on June 30, 2011. It does not apply to funds available to the Judicial Branch or the Legislative Branch. The bill was filed in the Senate on February 22 and has not yet been referred to a committee.

SB 58, Modify FMAP Cuts/Authorize Use of Credit Balance (Brunstetter, Hunt, Stevens Sponsors). SB 58 seeks to prevent reductions in Medicaid provider rates and retirement system contributions to "backfill" the expiring funds from the temporary increased FMAP (the federal Medicaid match) received under the Recovery Act. It also authorizes the use of $125 million of the funds in the unreserved credit balance on June 30, 2010 to address Medicaid liabilities incurred in the 2009‑2010 fiscal year. The bill received a favorable report from the Senate Appropriations committee and passed 2d and 3d reading in the Senate this week. It will now proceed to the House.

New Bills:

HB 154, Reform Medical Malpractice Evidentiary Rules (Faison Sponsor). This bill seeks to permit the introduction of evidence regarding the defendants’ insurance coverage in any civil action. It was filed in the House and has been referred to the House Judiciary Committee.

HB 183, HOA/Limit Foreclosures (Bryant, Hamilton, Gill, Moore, R. Sponsors). This bill prohibits Homeowners Associations from foreclosing on property where the debt securing the Association assessment lien consists solely of unpaid Homeowners Association dues or other costs associated with unpaid Homeowners Association dues. However, the Association may collect the lien as a money judgment. The bill was filed in the House on February 24 and has not yet been referred to a committee. HB 183 could prevent a person with a disability who has been unable to pay HOA dues for reasons related to their disability for any number of reasons - waiting to be approved for SSI/SSDI, disputed HOA assessments based on fair housing discimination, etc. - from losing their home to foreclsoure.

SB 95, Fair Housing Act Amendment (Kinnaird Sponsor). This bill seeks to prohibit discrimination on the basis of receipt of housing assistance (such as a Housing Choice voucher). This is the same bill that Senator Kinnaird filed in 2009, which passed successfully through the Senate but not through the House. It was referred to the Senate Commerce committee. A recent report to HUD examines the positive effect of such laws on voucher utilization and locational outcomes.

SB 96, Prohibit Request to Disclose Expunction (Kinnaird, McKissick Sponsors). This bill seeks to clear the public record of any entry of any arrest or criminal charge that has been expunged so that (i) the person who is entitled to and obtains the expunction may omit reference to the charges to potential employers and others and (ii) a records check for prior arrests and convictions will not disclose the expunged entries. It also prohibits any public or private sector employer from requiring an applicant for employment or admission to disclose information concerning any arrest or criminal charge against the applicant that has been expunged. It has been referred to the Senate Judiciary II Committee.

SB 108, Civil Litigation Costs Reform Act of 2011 (Rouzer Sponsor). This bill seeks to establish a general rule in civil actions that prevailing defendants be awarded attorneys’ fees. The bill was filed in the Senate on February 22 and has not yet been referred to a committee.

SB 115, Coverage for Treatment of Autism Disorders (Purcell, Garrou, Mansfield Sponsors). SB 115 seeks to require health benefit plans, including the State Health Plan, to provide coverage for treatment of Autism Spectrum Disorders. The bill was filed in the Senate on February 23 and has not yet been referred to a committee. The Autism Society of North Carolina is leading this effort, which would provide great benefit to families with health insurance seeking treatment for family members with autism.

SB 121, Eligibility Requirements/Public Assistance (Rouzer Sponsor). SB 121 seeks to require applicants for public assistance to undergo drug testing through the county department of social services before the applicant is eligible for public assistance. If an applicant fails to pass the substance abuse screening, the applicant would then be required to undergo substance abuse treatment. The bill also directs the Social Services Commission to adopt rules that establish requirements and policies for (i) substance abuse screenings of applicants, (ii) substance abuse treatment, when applicable, (iii) subsequent screenings of recipients after becoming eligible for public assistance, and (iv) any other requirements or policies the Commission deems relevant. The bill was filed in the Senate on February 23 and has not yet been referred to a committee. Disability Rights NC is very concerned about the implications of this bill. It provides additional requirements of applicants not included in federal law, and places a tremendous burden and expense on counties.

Week of February 21 Budget Update

2011-02-24T12:46:00.000-05:00

House and Senate budget chairs released targets for budget subcommittees this week. You can view the full document here. Not suprisingly, the numbers are lower than those in the Governor's budget - about $1.4 billion lower - and the subcommittees have been given lists of items to consider for cuts.

Education:

Base Budget (what it would likely take to continue services at current levels) - $11.913 Billion
Legislative Spending Target - $10.483 Billion
Difference - $1.43 Billion
Items to consider:

Consolidate/eliminate Smart Start and More at Four. (In consultation with the HHS Subcommittee
Determine alternative salary schedule based on performance. (Full Chairs item with Subcommittee Chair consultation).
Cap university enrollment.
Encourage more attendance at community colleges during freshman and sophomore years.
Reduce or eliminate higher education funding for less essential classes/degrees.
Fund higher education based on performance (i.e. graduation rates, measures of learning).
Tuition waivers.
Financial aid.

Health and Human Services:
Base Budget - $4.927 Billion
Legislative Spending Target - $4.336 Billion
Difference - $491 Million
Items to Consider:

Consolidate/Eliminate Smart Start and More At Four. (In consultation with the Education Subcommittee)
Provider Assessments.
Managed Care.
Maximize federal funds (block grants).
Evaluate federal maintenance of effort requirements.
Consolidation of divisions.
Medicaid parity with State Health Plan/Health Choice.
Copayments.
Consider closing facilities.
Eliminate structural redundancy (restructure the organization to streamline services).

The Health and Human Services committee heard two days of public comment this week. Commenters included lobbyists for advocacy organizations, as well as individuals with disabilities and their caregivers. The committee also heard from several vendors on cost-saving strategies today. Handouts from today's presentation are available on the committee website here. At this time, one presentation, from the ex-Georgia Medicaid Director is not posted (he discussed managed care in Georgia, which did not include Aged, Blind, Disabled). The other presentations included a respresentative from the Amerigroup Corporation, who proposed a managed care program for a small subset of the Long-Term care population, low acuity nursing home residents; MedSolutions, a group that currently contracts with NC to provide prior authorizatuon for radiology and ultrasound services; Triad Healthcare, a group focused on reducing the cost of musculoskeletal care; and Value Options, who proposed competitive bidding for a statewide behavioral health managed care waiver.

Justice and Public Safety
Base Budget - $2.207 bil
Legislative Spending Target - $2.067 bil
Difference - $140 mil
Items to Consider:

Justice Reinvestment Strategies.
Eliminate/modify programs or services.
Reduce inmate medical costs.
Shift/consolidate medical/treatment to State Health Plan or DHHS.
Close or consolidate facilities.
Consolidation of departments proposed by the Governor.
Policy changes to assure the lowest cost for housing misdemeanants.