PUBLIC POLICY UPDATE

Stakeholder Engagement GroupAugust 10, 2015

DHHS MENTAL HEALTH, DEVELOPMENTAL DISABILITIES AND SUBSTANCE ABUSE

State Task Force to improve collaboration between health care, justice and safety professionals

Medicaid Managed Care and capitated funding

Consolidating LME/MCO operations

Crisis Solutions Initiative for community support (November 2013)

Partnering with Department of Public Safety on ‘Youth Mental Health First Aiders’ and law enforcement training

ABLE ACT

Federal law signed in December 2014

Funds to be used for education, transportation, direct care, housing, technology, and others

NC filed S367 to create 529 plans for ABLE expenses

NC already has 529 plans for education

SEG led to Senate sponsorship at press conference

ABLE ACT – NORTH CAROLINA

S367 has passed both the North Carolina House and Senate

Final step – to be signed by the Governor There will likely be a signing ceremony this week;

will share details

No details yet on when individuals and families will be able to start using ABLE accounts.

INNOVATIONS WAIVER PROPOSAL

DHHS announced proposal and amendments to current Innovations Waiver

Based on statewide listening sessions last fall

Expands resource allocation and individual budgets

Promotes use of self-directed options

Makes changes to general structure to allow greater flexibility and community integration

INNOVATIONS WAIVER COMMENTS Waiver should be focused on meaningful

outcomes

Funding for services continues to vary significantly statewide

New Community Supports and Living to combine personal care and in-home skill building

What is the link between HCBS regulations, Workforce Investment and Opportunity Act (WIOA) regulations, and proposed Medicaid Managed Care regulations?

INNOVATIONS WAIVER COMMENTS Need greater focus on Person Centered Plan

(PCP) and Individual Service Plan (ISP) development

Need greater awareness and understanding of waiver services available to individuals and families

Integrated employment and limited funding for segregated settings

Due process and no hard limits on amount of services (L.S. v Wos)

NC STATE BUDGET

No changes to Medicaid eligibility, benefits or provider rates

$2 million for new Traumatic Brain Injury Waiver

Debate over funding Community Care North Carolina (CCNC)

$23 million to fund US Department of Justice settlement on community support for individuals with mental illness

NC STATE BUDGET- CONFERENCE

LME/MCO funding: Discussion on reducing funds to LME/MCOs and replacing it with existing cash balance

House Case Management Pilot Program: to provide Targeted Case Management for a small number of people with I/DD on the Innovations Waiver waiting list

Medical Expense Tax Deduction: Discussion on removing medical tax deduction

Education Funding: Increase funds to NC START, increase Teacher Assistants and reduce class sizes

MEDICAID REFORM

Fully managed system for ALL Medicaid dollars in 2 years

“Health Benefits Authority” to oversee and operate Medicaid

Keep LME/MCO structure for 3 years, then transition services to other managed care entities

HR 2646 HELPING FAMILIES IN MENTAL HEALTH CRISIS ACT

“THE MURPHY BILL” Bill restricts critical legal advocacy services by limiting the

activities of Protection and Advocacy of People with Mental Illness (PAIMI) Act funding grantees. 

Limits advocacy efforts to only situations of abuse and neglect, preventing self-advocacy assistance for individuals seeking independence through education, housing, or employment opportunities.

Bill bars advocates from raising concerns with decisions made by doctors, families, or guardians of people with mental illness.

P&A organizations would be required to provide “caregivers,” an undefined term, access to protected health information of an individual with a disability. 

 Prohibits P&A organizations from using the use any funds, including money raised from private donations, for use in an expansive definition of lobbying activities. P&A organizations, like Disability Rights NC, are currently

permitted to use these funds, and others, to lobby policymakers consistent with federal and state law 

Prevents Disability Rights NC from continuing systemic advocacy on behalf of people with mental illness by limiting advocacy efforts to only matters of abuse and neglect.

PAIMI grantees, such as Disability Rights NC, would be prevented from using funding to investigate death reports, advocate for employment, education, housing, community access, and other healthcare matters.

POTENTIAL ACTION: Sign on to a letter expressing concern over HR 2646

HR 2646 HELPING FAMILIES IN MENTAL HEALTH CRISIS ACT“THE MURPHY BILL”

NORTH CAROLINA MENTAL HEALTH AND SUBSTANCE USE TASK FORCE Announced by McCrory on July 14th Panel that will bring together the Executive, Legislative and Judicial

branches of government Aims to:

improve connections between health care, justice, public safety reduce stigma

21 members, including: State Supreme Court Chief Justice Mark Martin Health and Human Services Secretary Aldona Wos Sen. Tamara Barringer Rep. Susan Martin Martin will appoint seven members and McCrory will appoint 11

Report due by May 1, 2016

POTENTIAL ACTION: THE COMMISSION FOR MENTAL HEALTH, DEVELOPMENTAL DISABILITIES, AND SUBSTANCE ABUSES SERVICES IS SEEKING MEMBERS

Family members or individual with I/DD Needs to live in district 6, 10, or 11

6 - portions of Guilford, Alamance, Durham, Granville, and Orange counties, and all of Caswell, Person, Rockingham, Surry, and Stokes counties

10 – all of Cleveland, Gaston, Lincoln and Rutherford counties, and part of Catawba, Iredell, andBuncombe counties.

11 – Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Swain, Transylvania, Yancey

More vacancies are expected shortly Potentially: MH Family Member, SA

Family Member

QUESTIONS AND COMMENTS