2014 NC Short Session: That’s Hardly a Wrap!

Senators wrapped up the 2014 short session shortly after a midnight on Friday when they finally approved a state budget. House members  followed by issuing their final votes on Saturday. But there’s a catch, legislators will return this week to agree on an actual adjournment date as the House made more changes to the Senate’s original plan.

On August 14th, legislators will return for a brief additional session to take up any bills that might get vetoed by the Governor, wrap up any bills that got assigned to a conference committee, and attempt to complete nine different other provisions held over in adjournment resolutions. There’s still one more catch, legislators will return again on November 17th for a special session to discuss Medicaid Reform and possibly Coal Ash, and there is no word on how long this session will last.

So, while legislators have adjourned, they have not technically finished working. We should have a better idea of  their plan to meet again in August by the later part of this week.

Relevant Bills with Action:

SB 744 Appropriations Act of 2014: This bill has been in the works since session started. When legislators couldn’t agree, they turned to appointing a 42 member conference committee. Last weekend, they reported that they had come to an agreement. The conference committee budget highlights are below. With the Governor’s signature, this will be the state budget for the 2014 fiscal year. View the Money Report for further explanation on the spending plan with accompanying page numbers listed after each highlight. Please note, it is difficult to capture all the provisions in the budget due to the amazing variety of the social work profession so information below is only a snapshot of changes.

  • Provides funds to support the costs related to the education of children in private psychiatric residential treatment facilities (F-6).
  • Provides funding for one year for group home residents who were determined to be ineligible for Medicaid personal care services on or after January 1, 2013. The maximum monthly payment is set at $464.30 and is based on providing 33 hours of service per eligible recipient (G-3).
  • Reduces General Fund appropriation for the Home and Community Care Block Grant (HCCBG) by 3%, leaving a balance of $31,808,889. Cuts are $969,549 (G-4).
  • Changes the income eligibility for the State-County Special Assistance (SA) Program from a method that bases income eligibility on the payment rate for the facility type where the recipient resides, to a method based on the federal poverty level for all recipients regardless of where they reside. The SA eligibility level is set at 100% of the Federal Poverty Level. Current recipients of SA are grandfathered in and will continue to receive SA. (G-8).
  • Provides funding to replace $4.5 million in federal block grant funds that counties lost in 2013-14 that was utilized to pay for Child Protective Services (CPS) workers. An additional $2.8 million in funding is provided effective October 1, 2014 to reduce county departments of social services caseloads to an average of 10 families per worker performing Child Protective Services assessments (G-9).
  • Provides $4.5 million for Child Welfare In-Home Services to serve at-risk families (G-9).
  • Provides $218,538 recurring and $125,750 nonrecurring funds for the implementation of drug screening for Work First Benefits applicants (G-10).
  • Provides funding through incentives and rebates to end the waiting list of the Aids Drug Assistance Program (G-11).
  • Provides $2.2 million for community-based crisis services (G-15).
  • Provider rates are cut, once again, by 1% (G-18).
  • Mental Health Drug Management: Authorizes DHHS to impose controls including prior authorization, utilization review criteria, and any other restrictions on mental health drugs (G-18 and pg 87 of the budget).
  • Provision to hold special session in November to discuss Medicaid Reform (pg 87, budget).

Other Bills of Interest with Action:

HB 884 Dropout Prevention/Recovery Pilot Charter School: This bill establishes a two year pilot program for one charter school who has had students drop out. The purpose is to increase graduation rates and reengage students. The bill passed the House and Senate and was presented to the Governor for signature.

SJR 881 Adjournment: This bill directs legislators to adjourn but to return on August 14th and November 17th. As mentioned above, the November special legislative session will be focused on Medicaid Reform.

HJR 1276 Adjournment: The House version of the adjournment resolution. While the dates to return are the same as the Senate, the House has a few more issues to keep alive including any bills related to autism insurance reform. The House gives the Senate until Wednesday, August 6th to take up the new adjournment resolution.

2014 NC Legislative Short Session Nears End But No Deal on Budget

Last week, the General Assembly saw more action from the Senate than the House, and Senators have been meeting in Rules Committee the past couple of weeks to pass a few pressing bills. On Thursday, while discussing Medicaid Reform on the Senate floor, Senator Bryant sought an amendment to expand Medicaid. Unfortunately, but not surprisingly, the amendment failed.

Senators commented that this was the fourth time they voted down to expand Medicaid in the state. The House did meet on Thursday and Friday of last week, but they had little committee activity during the week. Despite filing an adjournment resolution for Friday, July 25th, the House does plan to meet this week. Rumors started over the weekend that legislators have reached another deal on the budget, so we hope to see the proposal this week.

Relevant bills with action:

short sessionHB 1181 Medicaid Modernization: This is the bill that would create a new department to oversee the operation of Medicaid and NC Health Choice run by a seven member appointed board, create full capitation by 2018 (instead of fee for service), integrate physical and behavioral health by 2016, and much more to reform Medicaid in our state. The bill went to committee to push back a few dates in the bill including the creation of the new department from August 1, 2014 to September 1, 2014. Senators will take a third, and final, vote on Monday night. The bill then has to get approval from the House before it is made law. No word yet on the House’s position on the bill.

HB 369 Criminal Law Changes: This bill passed out of the Senate last week and is scheduled to be heard on the House floor on Tuesday. The bill will allow NASW-NC and other partners to work with the Human Trafficking Commission on age appropriate sexual abuse education for students and teachers. The bill also makes several changes to various criminal laws such as expungement for certain offenses and higher penalties for providing inmates with cell phones.

HB 1133 Technical and Other Corrections: A bill that normally marks the end of the legislative session, the House and Senate have been working on a technical corrections bill to tie up loose ends of the session. Usually very technical in nature (spelling errors, corrections to previous bills, etc), the bill had a surprise section that would eliminate the Child Fatality Task Force that makes statewide recommendations to prevent unnecessary deaths of children.

During the existence of the Task Force, childhood death has decreased by as much as 32% in the past three decades. During floor debate, Representative Grier Martin (D-Wake), ran an amendment to eliminate this section of the bill and it passed overwhelmingly. The bill passed out of committee and passed the floor Friday. The bill will now go to the Senate.

2014 NC Short Session, Week 10: The Newest Medicaid Reform Plan

Bay Area Activists Protest Cuts To Medicaid

What a week at the General Assembly! The Senate decided to work on bills that were sitting in the Senate Rules Committee all last week and move them to the floor for votes.The most controversial was Medicaid Reform which the Senate proposes to create a completely new Department. The House did not meet last week and have nothing on their calendar for tonight, but it is possible that they meet later in the week to work on the bills the Senate is working through their Rules Committee.

Relevant Bills with Action:

HB 369 Criminal Law Changes: This is the omnibus bill that will expunge certain drug offenses and includes language on Erin’s Law. Under Section 4(a), the bill directs the Human Trafficking Commission to study the inclusion of age appropriate sexual abuse education in the classroom as well as gather information on sexual abuse in NC. Under the bill, the Commission is directed to work with several organizations to do this, including NASW-NC. The bill will be heard a third time tonight and, if it passes the Senate, will be sent to the House for concurrence.

HB 1181 North Carolina Medicaid Modernization: Last week, the Senate came up with an entirely new Medicaid plan. Under the new plan, the Division of Medical Assistance (DMA) would become an independent agency called the Department of Medical Benefits which would manage behavioral, physical and other specialized care for Medicaid and NC Health Choice recipients under a Managed Care Organization (MCO) or Accountable Care Organization (ACO) model.

The Senate scheduled this new Department to be created by August 1, 2014 and governed by a 7 member Board of Directors. The Senate plan also directs the Department of Health and Human Services to immediately cease any activities related to Medicaid reform. This plan is certainly fast-moving in the Senate and controversial among many. The bill is scheduled for a floor vote in the Senate tonight. If it passes, it will need to go to the House for concurrence. The Governor has already stated opposition to the new plan but the House has not spoken much for or against the bill.

Relevant Bills Filed:

HB 1276 Adjournment Sine Die: Yes, you read that correctly. The House bill filed last week sets adjournment for this Friday, July 25th. Keep in mind, the Senate filed an adjournment bill on June 27th, and legislators are still in session.

North Carolina Legislators Heading Towards Adjournment, Week 6 Recap

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Legislators are still going back and forth on an adjournment date, but our latest predictions are that legislators will go home by the second week of July if they are not done the week of July 4th. With a lot of controversial bills still on the table and not having reached an agreement on the budget yet, legislators have a lot more work to do before adjourning for the year. It is possible for legislators to leave with the current budget in place that was passed in the 2013 long session and only make a few adjustments to cover the shortfalls in Medicaid and the Department of Revenue.

Week 6 of the short session started off with a new regulatory reform bill that created controversy for many House members that did not see the bill until shortly before it was presented. Legislators commented that their uneasiness with the bill stemmed from the bill being more than just regulatory reform and included other provisions. This uneasiness slowed down the bill and it was sent back to the Regulatory Reform Committee before going to the floor. Additionally, on Wednesday night, House Health and Human Services Committee members introduced a new Medicaid Reform plan that makes big changes for provider payment and certain I/DD clients in Cardinal Behavioral Health’s catchment area. More information about these two bills is below.

Relevant bills with action:

  • HB 712 Clarifying Changes/Special Ed Scholarships: This bill allows $3,000 for eligible students with disabilities per semester to attend private schools and exempts certain private schools from child care licensure requirements. The exemption is extended to private schools that provide more than 6.5 hours of child care as long as they are not funded by childcare subsidies or NC Pre-K. This may open the door for more private schools to offer after school care knowing they do not have to be licensed and meet certain state requirements for health and safety. The bill passed the Senate and was sent back to the House.
  • HB 1181 Partnership for a Healthy North Carolina: This bill addresses a new Medicaid Reform plan. The plan would set provider capitation rates over the next 5 years instead of fee for service. This would make providers responsible for overspending but also allows them to absorb any savings. Section 10 of the bill directs Cardinal Behavioral Health to pilot integrated care, physical and mental health care, with certain I/DD clients living in group settings. This bill is supported by the Governor. It was discussed in committee this week and referred to Appropriations. Read more about this plan and House and Senate differences on Medicaid.
  • HB 1220 Hope 4 Haley and Friends: This bill establishes standards for the use of hemp oil extract from marijuana plants to be used for people suffering from intractable seizure disorders when no other medicines have worked. The bill sets up a registry of neurologists who prescribe the extract, caregivers, and patients. The bill also encourages UNC Chapel Hill, Duke University and Wake Forest University to further study the use of hemp oil extract. The bill passed the House and was sent to the Senate.
  • HJR 1262 Suicide Prevention Resolution: This bill directs the Legislative Research Commission to examine ways to prevent suicide among minors and veterans in NC as suicide in these populations more prevalent. The bill directs the commission to study evidenced-based treatment and prevention strategies and ways to engage and train professionals who work with minors and veterans. It was assigned to the Committee on Rules, Calendar, and Operations of the House.
  • SB 493 2014 Regulatory Reform Act: This bill makes several changes but the biggest for social workers is that it would direct insurance companies to cover autism services and allows for reimbursement of licensed clinical social workers to provide therapeutic care. This is the language from House Bill 498, supported by NASW-NC, that passed the House in the 2013 long session. The bill also establishes a board for Behavioral Analysts in NC (there is currently no state level licensing board for behavioral analysts). Additionally, the bill prohibits tanning bed use for minors under the age of 18. The bill is going through House committees at this time.
  • SB 761 Credit for Military Training: This bill enhances the effectiveness of military members and veterans obtaining occupational licenses and directs the Board of Governors for the University System and the State Board for Community Colleges to submit a plan that would grant college credit for students with military training. The bill passed the Senate and will be sent to the House.

Budget Conferees:

The Senate voted not to concur with House budget changes last week and a conference committee was established. The 41 member appointed committee is compromised mostly of appropriation chairs that will work to flush out the details and other influential legislators. Only one Democrat was appointed to the committee that will work to combine the House, Senate and Governor’s budgets. No persons of color were appointed. Legislative staff released a Comparison Report of the differences in the House and Senate budgets.

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