- Preliminary Injunction 3/29 Ordered by Federal Justice Flanagan in the Disability Rights NC suit against NC DHHS and PBH; posted on US Case Law page.
- added Updated Service Definitions (02/2012) and new Comparison Grid of Services document (01/2012) to CAP-MR/DD page.
- Second meeting with Dr. Pat Porter in Raleigh, 3/28.
- Met with Dr. Patricia Porter in Chapel Hill, 3/16.
- moved Correspondence page to top tab link Correspondence... (apparently there is too much data for a regular entry post; information truncates upon upload). Correspondence exchanges to date can be found there...
Updated Correspondence page with responses and replies to date.- Sent email to Joint Caucus Leader Rep. Marilyn Avila, 3/15.
- Email sent out today from DHHS Sandy Ellsworth announcing, "CMS has approved the extension of the Comprehensive and Supports CAP-I/DD waivers though June 28."
- Sent follow-up email to Representative Bill Current, 3/14.
- Sent follow-up email to Senator Tommy Tucker, 3/13.
- Attended the 3/13 Joint Legislative Oversight Committee meeting on Health and Human Services downtown Raleigh:
- DHHS Chief Clinical Operating Officer, Tara Larson, announced that Federal funding for Medicaid programs which provide Personal Care Services (PCS) in residential settings for Physically Disabled, Developmentally Disabled, and Elderly recipients is due to end April 30, 2012... And the State has NO PLAN.
- News article: NC personal care services for thousands may end byGary D. Robertson - Associated Press on NewsObserver.com; March 13, 2012.
- News article: Medicaid deadline jeopardizes residents of adult care homes by Lynn Bonner - LBONNER@NewsObserver.com
- Introductions and brief chats with: Senator Tommy Tucker, Representative Bill Current, Senator Fletcher Hartsell, Joint Caucus Leader / Representative Marilyn Avila... and though try as I might, couldn't seem to pin down Representative Nelson Dollar.
- expanded on 916 to Waiver Plan to include more background information on House Bill 916 to State Law to the new statewide Medicaid Waiver plan.
- changed name of About HB 916 header link to 916 to Waiver Plan.
- added page with MHDDSA and legal acronyms and legal terminology: Acronyms, Etc. If you have others to add, please let me know.
- Posted Disability Right NC's Federal Class Action Complaint on behalf of KC et al. against NC DHHS and PBH, filed 07/01/2011 and Memorandum in Support, filed 03/02/2012 to US Case Law page.
- Met with Disability Rights of North Carolina, 3/7.
- Posted Disability Rights NC's Federal Class Action Complaint on behalf of Pashby et al. against NC DHHS, filed 05/31/2011, as well as the DRNC Press Release to US Case Law page.
- Received a written response from Commissioner Lewis of the US Administration on Developmental Disabilities; posted in Correspondence, 3/5.
- Called the Office of the Governor to confirm receipt of hard copy letter and inquire of anticipated response date... Was told letter had been forwarded to NC DHHS for response on behalf of Governor Perdue; could not confirm whether or not the Governor herself had actually reviewed letter; requested that the letter be flagged for personal review and stressed the importance, that this is not merely a person letter but a letter that is very personal written on behalf of not only my DD child but the DD community across the State, 3/5.
- created new page Links with links to resources and information websites on everything from DD to government agencies, advocacy, and even Special Education. Please let me know if you have one (or more) to add!
31 March 2012
What's New in March?
March 2012 events and updates.
29 March 2012
DRNC Press Release on federal Court ruling
For Immediate Release
March 29, 2012
Raleigh, North Carolina – A federal District Court today ordered the State of North Carolina to halt reductions to home and community based services and restore lost services until the state Medicaid agency and its managed care contractor, Piedmont Behavioral Healthcare (PBH), comply with legal requirements for providing Medicaid beneficiaries with adequate notices and opportunities for impartial hearings when their services are denied, reduced or terminated. The Court noted that without an injunction, the plaintiffs—children and adults with disabilities—would experience deteriorating health, financial strains, and the threat of having to go into institutions to get care. “We are gratified by the court’s thorough, careful analysis and hopeful that the state and PBH will quickly accept this decision and correct their illegal practices,” said Doug Sea, an attorney at Legal Services of Southern Piedmont. “Scores of our most vulnerable citizens desperately need the services that have been taken away from them, without due process, to be promptly restored.”
Judge Louise Flanagan’s decision found that the plaintiffs are likely to succeed on the merits of their legal claims that the Medicaid agency and PBH are not complying with the most basic federal constitutional and statutory requirements for participating in the Medicaid program. “Health care coverage is complicated,” said National Health Law Program attorney Jane Perkins. “The court’s decision is welcome and important because it recognizes that the Medicaid agency and its managed care plan, PBH, have obligations to make sure that people with disabilities who are insured through Medicaid get timely and accurate information about why their services are being reduced or terminated and what they can do about it if they object.”
The suit, L.S., et al. v. Delia, et al. (No. 5:11-CV-354FL), was brought by Medicaid beneficiaries who suffer from chronic developmental disabilities and require significant medical or personal care. North Carolina operates a Home and Community Based Care program (North Carolina Innovations Waiver), which provides plaintiffs with access to services so that they can remain in their homes and avoid costly institutionalization. In March of 2011, PBH began implementing a new budgeting system which reduced services for beneficiaries that had previously been found necessary, even though their underlying conditions had not changed, and without the legally required notice explaining why the action was being taken. “Once again, the courts confirm that the desire to save resources does not allow a provider or state to deny due process,” said Disability Rights North Carolina attorney John Rittelmeyer.
Click here to view the court’s decision.
For questions or comments about the case, contact:
Doug Sea
dougs@lssp.org
704-971-2593
Jane Perkins
perkins@healthlaw.org
919-968-6308
John Rittelmeyer
John.rittelmeyer@disabilityrightsnc.org
919-856-2195
--
Vicki Smith, Executive Director
2626 Glenwood Avenue, Suite 550
Raleigh, NC 27608
Phone: 919-856-2195
TTY: 1-888-268-5535
Fax: 919-856-2244
25 March 2012
email invite to Representative Nelson Dollar
Republican Representative Nelson Dollar, from Cary, NC, has served 4 terms in the NC House of Representatives for District 36 of Wake County and was a Primary Sponsor of House Bill 916. Currently, he is Co-Chairman on both the Health and Human Services (Standing) Committee and the Joint Legislative Oversight Committee on Health and Human Services (Non-Standing) Committees, and a Member on the Health and Human Services Subcommittee on Mental Health. On February 15th of 2012, he filed for re-election.
25 March 2012
25 March 2012
Sent via email:
Dear Representative Dollar,
My name is Crystal J. De la Cruz - Hopper. Last month you and other members of the North Carolina General Assembly received a copy of a letter I sent to Governor Beverly Perdue. As I understand, both you and Senator Hartsell forwarded my correspondence along to Dr. Pat Porter; I'd like to take this opportunity to thank you for interest and assistance in opening a dialogue as a parent of a special little girl, Isabel.
While I sincerely hope that at some point in the near future, I might have the opportunity to meet with you personally to discuss concerns regarding the new Waiver changes, I can only imagine the overwhelming magnitude of the plate now before you and the stress you must be under dealing with issues at hand, so I recognize you probably could use a break. I am writing to you now to extend a personal invitation (all political chatter aside) for you and your family to come out and enjoy a game of baseball as perhaps you have never before experienced...
I profess, I've never been very sports-minded, perhaps because I personally lack the coordination required to walk and chew gum at the same time. My husband on the other hand, as I often jest, would no doubt find appeal in competitive squirrel-wrestling if it were am athletic event. I do enjoy World Cup soccer, Ice Hockey and occasionally Collage Basketball depending on who's playing so rarely do we enjoy sporting events as a family. Of course since our five-year-old son, Liam, has been taking Tae Kwon Do (and recently earned his Green Belt), I've added that to my short list of athletic interests, however the idea of baseball has always bored me to tears... that is, until our daughter joined the Miracle League of the Triangle.
Established in 2006, the Miracle League of the Triangle, is an amazing non-profit organization orchestrated by an extraordinary group of dedicated volunteers whose goal is simply to provide children with special needs an opportunity to play baseball.
There are numerous teams each with their own jerseys, hats, and coaches. There are bats and mitts, concession stands, a real ball field, bleachers, and dugouts... just like in baseball. There is even a proper baseball announcer and coolest of all, every child has their own "walk out" song.
Our Bella chose Eddie Murphy's rendition of "I'm a Believer" from the original Shrek soundtrack.
And this is why I'm now a baseball fan:
Watching the faces of all these kids out there playing ball... some smiles couldn't be missed and some wore theirs on the inside... some run their little hearts out around the bases and turn cartwheels, some walked slowly with braces and had to be carried to home, some made it on wheels, and one kid rounding second that just decided to sit down and take a load off mid-game (yep, that would've been MY child)... But no one struck out and everybody won... and the pride which ruminates from the field, from the stands, from each little being is nothing short of miraculous... because they are each a part of something bigger than themselves, something fun and spirited and above all, something that included them, counted them, and recognized them... cheered for and acknowledged them and for an hour, gave each child a sense of normalcy within their own diverse community of teammates, coaches, buddies, parents, friends, and even strangers where no one stared, no one ignored them and pretended that they weren't there... and everyone celebrated the fact that they were.
I would like to invite you Representative Dollar to take a time out and swing by with your wife, Lorrie, and son, Ian, for an afternoon, or even an hour, of sheer magic. Just one game. --Few things in my life raising a child with profound special needs have ever revived my soul and renewed my faith in humanity quite the way watching these kids play baseball has... I would be honored to share such a moment with you and yours.
I've attached both my daughter's schedule (Isabel plays on the Marlins) and the full team schedule for the Spring season, as well as my original letter to Governor Perdue just to refresh your memory, if needed, of who I am.
Miracle League games are held near to you in Cary at Andy's Foundation Field, Adams Elementary School, located at 805 Cary Towne Boulevard.
And you have my most sincere promise, should you wish to join us (and I dearly hope that you will), that I will do my utmost to assure your presence is respected and your time protected for sole purpose of enjoying some baseball magic and family. Hot dog's on me.
My contact information is below.
Sincere regards,
--
Crystal J. De la Cruz - Hopper
contact information...
contact information...
15 March 2012
email to Joint Caucus Leader Marilyn Avila
Republican Representative Marilyn Avila, from Raleigh, NC, has served 3 terms in the NC House of Representatives representing District 40 of Wake County. Currently, she serves as the Joint Caucus Leader for the House and is Co-Chairman on the Appropriations Subcommittee on Health and Human Services (Standing). She filed for re-election on February 17, 2012.
March 15, 2012
Sent via email:
To: Joint Caucus Leader, Representative Marilyn Avila [Marilyn.Avila@ncleg.net] with re-forwarded 02/25 email to Members of the NC House and attached letter and enclosures to Governor Perdue following the 03/13 Joint Legislative Oversight Committee Meeting on Health and Human Services:
Dear Joint Caucus Leader Representative Avila,
I wanted to follow up and thank you for taking the time to speak with me briefly Tuesday and allow me to introduce myself at the Joint Legislative Oversight Committee meeting on Health and Human Services. Though I am not among your direct voting constituents, I continue to reach out as a concerned North Carolina citizen, disability advocate, and mother of a beautiful, innocent daughter with profound special needs who, along with her family members, will be directly and critically affected by the implementation of NC House Bill 916 (now SL 2011-264) if allowed to proceed as intended.
I realize the enormity of the issues at hand regarding the State's exhausted budget and I understand that there are no easy answers for the predicament we as a State have placed ourselves. It is truly frightening on many levels... Realistically, I understand that this train cannot be turned around this late in its travels; it has, after all, been moving in this direction for quite a few years. Though I sincerely believe the destination can be changed.
I am just a mother and advocate; I am only an expert in the life of my child and my role as her mother and protector, and as such am also at a loss for perfect solutions, however, I know very well what the answers are not, because I live it every day. Of all the citizens of North Carolina, special populations are the least responsible for the State's economic crisis; it is truly heart-wrenching that they, as the most innocent and fragile among us, will once again pay the price for the ill-intent and misdeeds of those who should have protected their needs and interests.
Beyond my personal trials, I feel it's worth consideration that the impact of this new waiver's full implication upon our already strained economy is a topic that should be addressed... The reality of job loss for existing case managers as well as the many small provider agencies which will likely not be able to sustain themselves without the reimbursement rates for case management services. And of course, the effects of these changes upon the CAP workers we families depend upon for survival who already make next to nothing for the invaluable duties they perform, assuming we've found a good one... which I'm afraid goes back to personal trials.
From your website, key issues, and bio, It’s clear you are a woman of honorable priorities and values. You stand firm in your beliefs that every citizen deserves the opportunity to prosper, receive a quality education, have their family values protected, and that hard-working law-abiding citizens and their families should not be forced to sacrifice opportunities nor the fruits of their labors to those with no legal right to partake. I can appreciate your position on each of these issues and commend you on your plight.
As a taxpayer and the wife of a small business owner, I can certainly support your desire to protect our rights to provide for our family without struggle. I can appreciate wholeheartedly your agenda that all parents have the means to provide the best possible education for our children in hopes that they will one day become productive, compassionate leaders who shall make the world a better place for generations to come...
Though, how do I explain to my endearing typically-developing five year old that he has choices and rights when his sister does not? How do I teach my young son respect for life and honor of family when the State of North Carolina is sending the message that she is not as valuable and is therefore less deserving? How do I tell him that we, as a family, cannot have the same opportunities as other families because we are limited by the supports we receive for his sister but that it’s not her fault?
And what do I say when he inevitably asks, “Why?”
Perhaps this wasn't the intention, but ultimately this was the message delivered in June of 2011.
Please find attached, my letter and enclosures to Governor Beverly Eaves Perdue sharing our story and explaining, in more detail, the concerns shared by many families across our state regarding NC's new Medicaid Waiver plan. I appreciate your taking the time to read my words as I have put forth considerable time and effort into providing an intimate portrayal of the needs and challenges for our family - a situation not so dissimilar to many many other North Carolinians. I sincerely hope that you will contact me at any time should you have any questions and if I can in any way be of assistance in this matter.
I respectfully request a written response relaying your position and intentions regarding North Carolina's Medicaid Waiver plans for families across the State under House Bill 916. I would like to be kept abreast of any developments, actions, investigations, decisions, changes, and the like, relating to North Carolina's restructuring of the 1915(b)(c) Waivers under HB 916, services and supports, and the implementation of those services and supports. I also would very much like the opportunity to time to meet with you in person; if you could please have someone from your office contact me to set up a time that is convenient to you, I would be most grateful.
Thank you in advance for your time and attention on this vital issue detrimental to so many – the most vulnerable of North Carolina’s citizens and the families who love them.
Sincere regards,
--
Crystal J. De la Cruz - Hopper
March 15, 2012
Sent via email:
To: Joint Caucus Leader, Representative Marilyn Avila [Marilyn.Avila@ncleg.net] with re-forwarded 02/25 email to Members of the NC House and attached letter and enclosures to Governor Perdue following the 03/13 Joint Legislative Oversight Committee Meeting on Health and Human Services:
Dear Joint Caucus Leader Representative Avila,
I wanted to follow up and thank you for taking the time to speak with me briefly Tuesday and allow me to introduce myself at the Joint Legislative Oversight Committee meeting on Health and Human Services. Though I am not among your direct voting constituents, I continue to reach out as a concerned North Carolina citizen, disability advocate, and mother of a beautiful, innocent daughter with profound special needs who, along with her family members, will be directly and critically affected by the implementation of NC House Bill 916 (now SL 2011-264) if allowed to proceed as intended.
I realize the enormity of the issues at hand regarding the State's exhausted budget and I understand that there are no easy answers for the predicament we as a State have placed ourselves. It is truly frightening on many levels... Realistically, I understand that this train cannot be turned around this late in its travels; it has, after all, been moving in this direction for quite a few years. Though I sincerely believe the destination can be changed.
I am just a mother and advocate; I am only an expert in the life of my child and my role as her mother and protector, and as such am also at a loss for perfect solutions, however, I know very well what the answers are not, because I live it every day. Of all the citizens of North Carolina, special populations are the least responsible for the State's economic crisis; it is truly heart-wrenching that they, as the most innocent and fragile among us, will once again pay the price for the ill-intent and misdeeds of those who should have protected their needs and interests.
Beyond my personal trials, I feel it's worth consideration that the impact of this new waiver's full implication upon our already strained economy is a topic that should be addressed... The reality of job loss for existing case managers as well as the many small provider agencies which will likely not be able to sustain themselves without the reimbursement rates for case management services. And of course, the effects of these changes upon the CAP workers we families depend upon for survival who already make next to nothing for the invaluable duties they perform, assuming we've found a good one... which I'm afraid goes back to personal trials.
From your website, key issues, and bio, It’s clear you are a woman of honorable priorities and values. You stand firm in your beliefs that every citizen deserves the opportunity to prosper, receive a quality education, have their family values protected, and that hard-working law-abiding citizens and their families should not be forced to sacrifice opportunities nor the fruits of their labors to those with no legal right to partake. I can appreciate your position on each of these issues and commend you on your plight.
As a taxpayer and the wife of a small business owner, I can certainly support your desire to protect our rights to provide for our family without struggle. I can appreciate wholeheartedly your agenda that all parents have the means to provide the best possible education for our children in hopes that they will one day become productive, compassionate leaders who shall make the world a better place for generations to come...
Though, how do I explain to my endearing typically-developing five year old that he has choices and rights when his sister does not? How do I teach my young son respect for life and honor of family when the State of North Carolina is sending the message that she is not as valuable and is therefore less deserving? How do I tell him that we, as a family, cannot have the same opportunities as other families because we are limited by the supports we receive for his sister but that it’s not her fault?
And what do I say when he inevitably asks, “Why?”
Perhaps this wasn't the intention, but ultimately this was the message delivered in June of 2011.
Please find attached, my letter and enclosures to Governor Beverly Eaves Perdue sharing our story and explaining, in more detail, the concerns shared by many families across our state regarding NC's new Medicaid Waiver plan. I appreciate your taking the time to read my words as I have put forth considerable time and effort into providing an intimate portrayal of the needs and challenges for our family - a situation not so dissimilar to many many other North Carolinians. I sincerely hope that you will contact me at any time should you have any questions and if I can in any way be of assistance in this matter.
I respectfully request a written response relaying your position and intentions regarding North Carolina's Medicaid Waiver plans for families across the State under House Bill 916. I would like to be kept abreast of any developments, actions, investigations, decisions, changes, and the like, relating to North Carolina's restructuring of the 1915(b)(c) Waivers under HB 916, services and supports, and the implementation of those services and supports. I also would very much like the opportunity to time to meet with you in person; if you could please have someone from your office contact me to set up a time that is convenient to you, I would be most grateful.
Thank you in advance for your time and attention on this vital issue detrimental to so many – the most vulnerable of North Carolina’s citizens and the families who love them.
Sincere regards,
--
Crystal J. De la Cruz - Hopper
Mother, Disability Advocate, & Concerned NC Citizen
contact information...
contact information...
14 March 2012
email to Representative Bill Current
Republican Representative William Current from Gastononia, NC, has served 4 terms in the NC House of Representatives representing District 109, Gaston County. Currently, he is a Co-Chairman on the Health and Human Services (Standing) Committee and Member on the Appropriations Subcommittee on Health and Human Services (Standing), Health and Human Services Subcommittee on Mental Health and the Joint Legislative Oversight Committee on Health and Human Services (Standing), (Non-Standing). He has not filed for re-election.
March 14, 2012
Sent via email:
To: Representative Bill Current with re-forwarded 02/25 email to Members of the NC House and attached letter and enclosures to Governor Perdue per request following the 03/13 Joint Legislative Oversight Committee Meeting on Health and Human Services:
Dear Representative / Dr. Current or Bill per your request,
First, please know that my southern upbringing makes it difficult to address you informally as Bill, though I find your insistence in being recognized as a sincere person of the people both admirable and refreshing. I hope you don't mind my saying, upon meeting you briefly yesterday you reminded me very much of my late grandfather (in his best ways), a WWII veteran and former Johnston County Magistrate, who was a strong, unbending personality of sincerity and character to say the least.
Once more, I wanted to thank you kindly for taking a moment to chat with me as a parent of a beautiful little girl with profound developmental disabilities who, along with her family and many families such as ours across the state, will be directly and critically affected by the new Medicaid Waiver plan under NC House Bill 916 (now SL 2011-264) if allowed to proceed as intended.
I realize the enormity of the issues at hand regarding the State's exhausted budget and I understand that there are no easy answers for the predicament we as a State have placed ourselves. It is truly frightening on many levels... Realistically, I understand that this train cannot be turned around this late in its travels; it has, after all, been moving in this direction for quite a few years. Though I sincerely believe the destination can be changed.
I am just a mother and advocate; I am only an expert in the life of my child and my role as her mother and protector, and as such am also at a loss for perfect solutions, however, I know very well what the answers are not, because I live it every day. Of all the citizens of North Carolina, special populations are the least responsible for the State's economic crisis; it is truly heart-wrenching that they, as the most innocent and fragile among us, will once again pay the price for the ill-intent and misdeeds of those who should have protected their needs and interests.
You mentioned when we spoke that you would only be around (in your legislative seat) through December and expressed confidence in the ability of 'the smart, younger fellows to sort it all out.' I can only imagine that the roles of Members in the NC General Assembly are demanding and no doubt tireless; I do not doubt the hard work and dedication of all the members of legislature. Though with all due respect, I wish I shared your confidence. You see, there is a world of difference between intelligence and wisdom. Just as one cannot possibly know the life nor hardships of another without walking a mile in those ragged shoes, it is the experience of life itself, full of change and challenge, personal growth, sacrifice, humility and gratitude from which wisdom derives.
As mentioned, please see attached my letter and enclosures to Governor Perdue outlining in more detail my concerns and sharing an intimate glimpse into our life and a not-so-dissimilar story to many families across the State of North Carolina. Please, please take a few moments to read the words; they represent the lives of many.
I welcome you to contact me at any time should you have questions or if I can be of any assistance. I would very much like the opportunity to meet with you again for further dialogue at any time that is convenient for you. I can make myself available any time you're in Raleigh and would even be willing to drive to Gaston County. I work with my husband, a local small business owner, so that occasionally affords me flexibility - to love my child the best way I know how.
Thank you in advance Bill for your attention and consideration.
I look forward to speaking with you soon.
Kind regards,
March 14, 2012
Sent via email:
To: Representative Bill Current with re-forwarded 02/25 email to Members of the NC House and attached letter and enclosures to Governor Perdue per request following the 03/13 Joint Legislative Oversight Committee Meeting on Health and Human Services:
Dear Representative / Dr. Current or Bill per your request,
First, please know that my southern upbringing makes it difficult to address you informally as Bill, though I find your insistence in being recognized as a sincere person of the people both admirable and refreshing. I hope you don't mind my saying, upon meeting you briefly yesterday you reminded me very much of my late grandfather (in his best ways), a WWII veteran and former Johnston County Magistrate, who was a strong, unbending personality of sincerity and character to say the least.
Once more, I wanted to thank you kindly for taking a moment to chat with me as a parent of a beautiful little girl with profound developmental disabilities who, along with her family and many families such as ours across the state, will be directly and critically affected by the new Medicaid Waiver plan under NC House Bill 916 (now SL 2011-264) if allowed to proceed as intended.
I realize the enormity of the issues at hand regarding the State's exhausted budget and I understand that there are no easy answers for the predicament we as a State have placed ourselves. It is truly frightening on many levels... Realistically, I understand that this train cannot be turned around this late in its travels; it has, after all, been moving in this direction for quite a few years. Though I sincerely believe the destination can be changed.
I am just a mother and advocate; I am only an expert in the life of my child and my role as her mother and protector, and as such am also at a loss for perfect solutions, however, I know very well what the answers are not, because I live it every day. Of all the citizens of North Carolina, special populations are the least responsible for the State's economic crisis; it is truly heart-wrenching that they, as the most innocent and fragile among us, will once again pay the price for the ill-intent and misdeeds of those who should have protected their needs and interests.
You mentioned when we spoke that you would only be around (in your legislative seat) through December and expressed confidence in the ability of 'the smart, younger fellows to sort it all out.' I can only imagine that the roles of Members in the NC General Assembly are demanding and no doubt tireless; I do not doubt the hard work and dedication of all the members of legislature. Though with all due respect, I wish I shared your confidence. You see, there is a world of difference between intelligence and wisdom. Just as one cannot possibly know the life nor hardships of another without walking a mile in those ragged shoes, it is the experience of life itself, full of change and challenge, personal growth, sacrifice, humility and gratitude from which wisdom derives.
As mentioned, please see attached my letter and enclosures to Governor Perdue outlining in more detail my concerns and sharing an intimate glimpse into our life and a not-so-dissimilar story to many families across the State of North Carolina. Please, please take a few moments to read the words; they represent the lives of many.
I welcome you to contact me at any time should you have questions or if I can be of any assistance. I would very much like the opportunity to meet with you again for further dialogue at any time that is convenient for you. I can make myself available any time you're in Raleigh and would even be willing to drive to Gaston County. I work with my husband, a local small business owner, so that occasionally affords me flexibility - to love my child the best way I know how.
Thank you in advance Bill for your attention and consideration.
I look forward to speaking with you soon.
Kind regards,
--
Crystal J. De la Cruz - Hopper
Mother, Disability Advocate, & Concerned NC Citizen
contact information...
13 March 2012
email to Senator Tommy Tucker
March 13, 2012
Sent via email:
To: Senator Tommy Tucker
with re-forwarded 02/25 email to Members of the NC Senate and attached
letter and enclosures to Governor Perdue per request following the 03/13
Joint Legislative Oversight Committee Meeting on Health and Human
Services:
Dear Senator Tucker,
I very much appreciate your taking the time today to speak with me briefly regarding my concerns as a parent of a beautiful little girl with profound developmental disabilities. I know how busy you must be and how full your plate as a member of the NC General Assembly, committee member and vice-chair on the various Health and Human Services related committees, so I value the time you spared for me to chat.
I realize the enormity of the issues at hand regarding the State's exhausted budget and I understand that there are no easy answers for the predicament we as a State have placed ourselves. It is truly frightening on many levels... Realistically, I understand that this train cannot be turned around this late in its travels; it has, after all, been moving in this direction for quite a few years. Though I sincerely believe the destination can be changed.
I am just a mother and advocate; I am only an expert in the life of my child and my role as her mother and protector, and as such am also at a loss for perfect solutions, however, I know very well what the answers are not, because I live it every day.
As mentioned, please see attached my letter and enclosures to Governor Perdue outlining in more detail my concerns and sharing an intimate glimpse into our life and a not-so-dissimilar story to many families across the State of North Carolina. Please, please take a few moments to read the words; they represent the lives of many.
Beyond my personal trials, I feel it's worth consideration that the impact of this new waiver's full implication upon our already strained economy is a topic that should be addressed... The reality of job loss for existing case managers as well as the many small provider agencies which will likely not be able to sustain themselves without the reimbursement rates for case management services. And of course, the effects of these changes upon the CAP workers we families depend upon for survival who already make next to nothing for the invaluable duties they perform, assuming we've found a good one... which I'm afraid goes back to personal trials.
I welcome you to contact me at any time should you have questions or if I can be of any assistance. I would very much like the opportunity to meet with you again for further dialogue at any time that is convenient for you. I can make myself available any time you're in Raleigh and would even be willing to drive to Union County. I work with my husband, a local small business owner, so that occasionally affords me flexibility - to love my child the best way I know how.
Thank you in advance Senator Tucker for your attention and consideration.
I look forward to speaking with you soon.
Kind regards,
--
Crystal J. De la Cruz - Hopper
Mother, Disability Advocate, & Concerned NC Citizen
contact information...
09 March 2012
Acronyms, Etc.
Acronyms
Disability, Medicaid and HHS...
ACH = Adult Care Home
ADA = Americans with Disabilities Act
ADL = Activities of Daily Living (i.e. eating, bathing, walking...)
APS = Adult Protective Services
CAP = Community Alternative Program
CAP-DA = Community Alternatives Program for Disabled Adults
CD = Certain Disabled
CD-SA = Certain Disabled - Special Assistance
CHS = Community Health Services
CIP = Crisis Intervention Program
CPI = Continuous Period of Institutionalization
CMS = Centers for Medicare & Medicaid Services (formerly HCFA)
CNR = Continued Needs Review
CPS = Child Protective Services
DA = Disabled Adult
DAC = Disabled Adult Child
DD = Developmentally Disabled
DDS = Disability Determination Services
DEC = Developmental Evaluation Center
DHHS = Department of Health & Human Services
DMA = Division of Medical Assistance
DME = Durable Medical Equipment
DSS = Department of Social Services (County)
DSS = Division of Social Services (State)
EPSDT = Early and Periodic Screening, Diagnosis, and Treatment
HCWD = Health Coverage for Workers with Disabilities
HCS = Home and Community Supports
HHS = Health and Human Services (US)
HIPAA = Health Insurance Portability and Accountability Act
ICF = Intermediate Care Facility
ICF-MR = Intermediate Care Facility - Mental Retardation
IADL = Instrumental Activities of Daily Living (i.e. obtaining food, cooking, washing, clothes, managing medication...)
ICFMR = Intermediate Care Facility for MR/DD
I/DD = Intellectually / Developmentally Disabled
IMD = Institution for Mental Disease
IPV = Intentional Program Violation
LME = Local Management Entity
LTC = Long Term Care
M-AA = Medical Assistance to the Aged
M-AB = Medical Assistance to the Blind
M-AD = Medical Assistance to the Disabled
MFP = Money Follows the Person
MH = Mental Health
MID = Medicaid Identification Number
MMIS = Medicaid Management Information System
MN = Medically Needy
MPR = Medicaid Program Representative
MR = Mentally Retarded
MR-2 = Level of Care Designation Form for Mentally Retarded
MR/DD = Mentally Retarded / Developmentally Disabled
MRR = Medicaid Reimbursement Rate
MSW = Master of Social Work
NF = Nursing Facility (e.g. nursing home)
PBH = Piedmont Behavioral Health
PCP = Personal Care Provider
PCS = Personal Care Services
PDN = Private Duty Nursing
PLA = Private Living Arrangement
PNA = Personal Needs Allowance
PRTF = Psychiatric Residential Treatment Facility
QDWI = Qualified Working Disabled Individual (same as M-WD)
QI = Qualifying Individuals
QI1 = Qualifying Individuals 1 (same as MQB-E)
QMB = Qualified Medicare Beneficiaries (same as MQB-Q)
SA =Special Assistance
SA = Substance Abuse
S-AA = Special Assistance for the Aged
S-AB = Special Assistance for the Blind
S-AD = Special Assistance for the Disabled
SA-IH = Special Assistance In Home Demonstration Project
SAS = Substance Abuse Services
SBHF = State Boarding Home Funds
S/C SA = State/County Special Assistance for Adults
S-CD = Special Assistance for the Certain Disabled
SCU = Special Care Units in Adult Care Homes
SIS = Supports Intensity Scale
SNF = Skilled Nursing Facility
SNAP = Support Needs Assessment Profile
SPA = State Plan Amendment
SSA = Social Security Administration
SSI = Supplemental Security Income
SW = Social Worker
TMA = Transitional Medicaid
UMN = Unmet Medical Needs
VR = Vocational Rehabilitation
Law and Legal...
ADA = Americans with Disabilities Act
ALJ = Administrative Law Judge
AMND = Amended Complaint
AOC = Administrative Office of the Courts
ATTY = Attorney
CFR = Code of Federal Regulations
CNFJ = Confession of Judgment
COC = Clerk of Court
COMP = Complaint
CSC = Clerk of Superior Court
DISM = Dismiss / Dismissal
DOJ = Department of Justice
GAL = Guardian ad Litem
GS = General Statutes
NCAC = North Carolina Administrative Code
NCGC = North Carolina General Code
NCGS = North Carolina General Statutes
PL = Public Law
SSA = Social Security Act
ROD = Registrar of Deeds
USC = United States Code
Legal Terminology
As explained by the North Carolina Court System.
Alternative Dispute Resolution - working with a mediator who helps two parties in dispute resolve their differences mutually, or with an arbitrator who listens to the parties and makes a non-binding decision. Both of these approaches take place outside the formal court process, and that frees up valuable court resources.
Answer - the defendant's response to the plaintiff's complaint. The answer admits or denies the claims in the plaintiff's complaint.
Appeal - a legal action which seeks review by a court of a lower court decision.
Appellant - the side that lost in the trial court and has filed an appeal. Sometimes called the petitioner.
Appellee - generally, the side that won in the trial court, and whose victory is being appealed by the losing side. Sometimes called the respondent.
Burden of Proof - the duty to prove disputed facts. In criminal cases, the burden rests on the prosecutors. In civil cases, the burden most often is carried by the plaintiff.
Civil - not criminal. In a civil action, one person or entity is suing another, usually for money damages.
Clerks of Court - the clerks of Superior Court in each county of the state exercise the judicial power of the state in the probate of wills, administration of estates, and the handling of special proceedings such as adoptions and foreclosures. Clerks also keep the county court records. They are elected to four-year terms.
Complaint - the document which, when filed with the court, initiates a lawsuit. It sets forth the plaintiff's claims against the defendant.
Continuance - the postponement of an action pending in court to another date.
Court of Appeals - 15 judges, elected statewide, make up this intermediate appellate court. Judges sit in rotating panels of three, and they hear appeals from the trial courts in all civil cases and all criminal cases except death penalty cases, and also hear appeals from certain state administrative agencies. Voters elect the judges in statewide, partisan elections for eight-year terms.
Court Reporters - court personnel who record trial proceedings word-for-word. Reporters who use a stenotype machine must be able to write at least 225 spoken words per minute. Those who use a stenomask must be able to record 250 words a minute. If the case is appealed, the verbatim record must be transcribed promptly for the appellate court.
Damages - money awarded for an injury or loss due to the unlawful act or negligence of another.
De Facto - Latin, meaning in fact or actually.
Defendant - a person accused of a crime or a person being sued in a civil action.
De Jure - Latin meaning in law or lawfully.
Dismissal with Prejudice - prevents an identical lawsuit from being filed later.
Dismissal without Prejudice - allows a later filing.
District Court - in civil cases, judges hear cases for all actions involving $10,000 or less. District Court also has preliminary jurisdiction over felony cases and over the trial of all misdemeanors and infractions. This court also has exclusive jurisdiction over all juvenile proceedings, mental health hospital commitments and domestic relations cases. The state has 235 District Court judges who are elected by the voters for a four-year term and serve in 39 districts.
Drug Treatment Courts - a court-based intervention program to ensure that chemically dependent offenders receive appropriate treatment and are held strictly accountable for their behavior. Offenders participate for a minimum of one year, appearing before a judge twice a month to report on their progress or setbacks. If the offender does not comply with the strict terms of the program, the judge may order jail time.
Evidence - documents, objects or testimony admitted in a trial to prove certain facts.
Foreign Language Interpreter Project - using grant funding, the Foreign Language Interpreter Project is certifying interpreters for the courts. Interpreters are trained to translate for the court word for word what a non-English speaking person is saying, not what the interpreter thinks the person is trying to say. This project sponsors seminars on the subject, looking for potential court interpreters. It also trains and certifies court interpreters.
Guardian ad Litem - a person appointed by the court to represent the interest of a minor or incompetent during the litigation.
Guardian ad Litem Program - when a child is thrust into the legal system because of abuse, neglect or dependency, a trained GAL volunteer researches the child's home and community situation. That volunteer acts as the child's advocate in court, giving a judge information on the child's situation and making recommendations for the child's best interests including a safe, permanent home. More than 3,600 volunteers represent 12,000 children in every county across the state.
Hung Jury - one whose members cannot reach a verdict because of differences of opinion.
In Camera - in a judge's chambers, outside the presence of a jury and the public.
Injunction - a court order preventing one or more specific parties from taking some action. A preliminary injunction often is issued to allow fact-finding so a judge can determine whether a permanent injunction is justified.
Judge or Justice - a public official who hears and decides cases brought before a court of law. North Carolina has seven justices on the Supreme Court, 15 judges on the Court of Appeals, 105 Superior Court judges, and 235 District Court judges.
Judgment - the decision of a judge or jury resolving a dispute and determining the rights and obligations of the parties.
Judicial Branch - one of the three co-equal branches of government. The Legislative Branch enacts laws, the Executive Branch enforces laws, and the Judicial Branch interprets and applies laws in specific cases.
Jurisdiction - the power and authority of the court to hear certain cases. For example, the jurisdiction for divorce cases is in civil court.
Lien - a legal claim usually against a piece of land for payment of some debt, obligation, or duty. Some forms of liens are tax liens and materialman's liens.
Litigation - a controversy in a court.
Mediated Settlement Conferences - a statewide program dealing with civil Superior Court cases. When parties are in litigation, a mediator helps them arrive at mutually agreeable solutions. The state has nearly 900 certified mediators who conduct mediated settlement conferences. More than half of the cases are settled in this way.
Moot - not subject to a court ruling because the controversy has not actually arisen, or has ended.
Motion - A document filed with the court seeking to obtain a ruling or order from the court that is favorable to the party filing a motion.
Notice - a formal, written announcement communicating scheduling information or other information about a case. The original notice is filed with the clerk of Superior Court and copies are mailed or hand-delivered to parties to the litigation.
Party - the plaintiff or defendant in a case. The plaintiff is the party who files the lawsuit and the defendant is the party who is being sued.
Plaintiff - the one who initially brings a suit.
Preliminary Hearings - held to determine if there is sufficient evidence to hold a trial.
Preponderance of Evidence - evidence as a whole which shows the fact is more likely than not.
Reasonable Doubt - doubt based on reason, arising from evidence or lack of evidence.
Statute of Limitations - the time within which a lawsuit must be filed. The deadline can vary, depending on the type of lawsuit.
Supreme Court - the seven-member Supreme Court is the state's highest court. Justices decide questions of law in civil and criminal cases on appeal. The Supreme Court has the power to control and supervise the proceedings of other courts and has the authority to set court schedules and promulgate rules of practice and procedure for the trial courts. Voters elect the chief justice and the six associate justices of the Supreme Court for eight-year terms.
Tort - A civil, not criminal, wrong. An injury against a person or property.
Trial Court Administrators - North Carolina has 13 trial court administrators serving in 14 of the state's 46 Superior Court districts. They assist in managing the day-to-day administrative operations of the trial courts, including civil case calendaring, jury use, and maintaining local court rules.
Venue - The particular county in which the court with jurisdiction may hear the case for example, a divorce action is filed in civil court in the county where either the plaintiff or defendant resides).
Voir Dire - Jury selection process of questioning prospective jurors.
Disability, Medicaid and HHS...
ACH = Adult Care Home
ADA = Americans with Disabilities Act
ADL = Activities of Daily Living (i.e. eating, bathing, walking...)
APS = Adult Protective Services
CAP = Community Alternative Program
CAP-DA = Community Alternatives Program for Disabled Adults
CD = Certain Disabled
CD-SA = Certain Disabled - Special Assistance
CHS = Community Health Services
CIP = Crisis Intervention Program
CPI = Continuous Period of Institutionalization
CMS = Centers for Medicare & Medicaid Services (formerly HCFA)
CNR = Continued Needs Review
CPS = Child Protective Services
DA = Disabled Adult
DAC = Disabled Adult Child
DD = Developmentally Disabled
DDS = Disability Determination Services
DEC = Developmental Evaluation Center
DHHS = Department of Health & Human Services
DMA = Division of Medical Assistance
DME = Durable Medical Equipment
DSS = Department of Social Services (County)
DSS = Division of Social Services (State)
EPSDT = Early and Periodic Screening, Diagnosis, and Treatment
HCWD = Health Coverage for Workers with Disabilities
HCS = Home and Community Supports
HHS = Health and Human Services (US)
HIPAA = Health Insurance Portability and Accountability Act
ICF = Intermediate Care Facility
ICF-MR = Intermediate Care Facility - Mental Retardation
IADL = Instrumental Activities of Daily Living (i.e. obtaining food, cooking, washing, clothes, managing medication...)
ICFMR = Intermediate Care Facility for MR/DD
I/DD = Intellectually / Developmentally Disabled
IMD = Institution for Mental Disease
IPV = Intentional Program Violation
LME = Local Management Entity
LTC = Long Term Care
M-AA = Medical Assistance to the Aged
M-AB = Medical Assistance to the Blind
M-AD = Medical Assistance to the Disabled
MFP = Money Follows the Person
MH = Mental Health
MID = Medicaid Identification Number
MMIS = Medicaid Management Information System
MN = Medically Needy
MPR = Medicaid Program Representative
MR = Mentally Retarded
MR-2 = Level of Care Designation Form for Mentally Retarded
MR/DD = Mentally Retarded / Developmentally Disabled
MRR = Medicaid Reimbursement Rate
MSW = Master of Social Work
NF = Nursing Facility (e.g. nursing home)
PBH = Piedmont Behavioral Health
PCP = Personal Care Provider
PCS = Personal Care Services
PDN = Private Duty Nursing
PLA = Private Living Arrangement
PNA = Personal Needs Allowance
PRTF = Psychiatric Residential Treatment Facility
QDWI = Qualified Working Disabled Individual (same as M-WD)
QI = Qualifying Individuals
QI1 = Qualifying Individuals 1 (same as MQB-E)
QMB = Qualified Medicare Beneficiaries (same as MQB-Q)
SA =Special Assistance
SA = Substance Abuse
S-AA = Special Assistance for the Aged
S-AB = Special Assistance for the Blind
S-AD = Special Assistance for the Disabled
SA-IH = Special Assistance In Home Demonstration Project
SAS = Substance Abuse Services
SBHF = State Boarding Home Funds
S/C SA = State/County Special Assistance for Adults
S-CD = Special Assistance for the Certain Disabled
SCU = Special Care Units in Adult Care Homes
SIS = Supports Intensity Scale
SNF = Skilled Nursing Facility
SNAP = Support Needs Assessment Profile
SPA = State Plan Amendment
SSA = Social Security Administration
SSI = Supplemental Security Income
SW = Social Worker
TMA = Transitional Medicaid
UMN = Unmet Medical Needs
VR = Vocational Rehabilitation
Law and Legal...
ADA = Americans with Disabilities Act
ALJ = Administrative Law Judge
AMND = Amended Complaint
AOC = Administrative Office of the Courts
ATTY = Attorney
CFR = Code of Federal Regulations
CNFJ = Confession of Judgment
COC = Clerk of Court
COMP = Complaint
CSC = Clerk of Superior Court
DISM = Dismiss / Dismissal
DOJ = Department of Justice
GAL = Guardian ad Litem
GS = General Statutes
NCAC = North Carolina Administrative Code
NCGC = North Carolina General Code
NCGS = North Carolina General Statutes
PL = Public Law
SSA = Social Security Act
ROD = Registrar of Deeds
USC = United States Code
Legal Terminology
As explained by the North Carolina Court System.
Alternative Dispute Resolution - working with a mediator who helps two parties in dispute resolve their differences mutually, or with an arbitrator who listens to the parties and makes a non-binding decision. Both of these approaches take place outside the formal court process, and that frees up valuable court resources.
Answer - the defendant's response to the plaintiff's complaint. The answer admits or denies the claims in the plaintiff's complaint.
Appeal - a legal action which seeks review by a court of a lower court decision.
Appellant - the side that lost in the trial court and has filed an appeal. Sometimes called the petitioner.
Appellee - generally, the side that won in the trial court, and whose victory is being appealed by the losing side. Sometimes called the respondent.
Burden of Proof - the duty to prove disputed facts. In criminal cases, the burden rests on the prosecutors. In civil cases, the burden most often is carried by the plaintiff.
Civil - not criminal. In a civil action, one person or entity is suing another, usually for money damages.
Clerks of Court - the clerks of Superior Court in each county of the state exercise the judicial power of the state in the probate of wills, administration of estates, and the handling of special proceedings such as adoptions and foreclosures. Clerks also keep the county court records. They are elected to four-year terms.
Complaint - the document which, when filed with the court, initiates a lawsuit. It sets forth the plaintiff's claims against the defendant.
Continuance - the postponement of an action pending in court to another date.
Court of Appeals - 15 judges, elected statewide, make up this intermediate appellate court. Judges sit in rotating panels of three, and they hear appeals from the trial courts in all civil cases and all criminal cases except death penalty cases, and also hear appeals from certain state administrative agencies. Voters elect the judges in statewide, partisan elections for eight-year terms.
Court Reporters - court personnel who record trial proceedings word-for-word. Reporters who use a stenotype machine must be able to write at least 225 spoken words per minute. Those who use a stenomask must be able to record 250 words a minute. If the case is appealed, the verbatim record must be transcribed promptly for the appellate court.
Damages - money awarded for an injury or loss due to the unlawful act or negligence of another.
De Facto - Latin, meaning in fact or actually.
Defendant - a person accused of a crime or a person being sued in a civil action.
De Jure - Latin meaning in law or lawfully.
Dismissal with Prejudice - prevents an identical lawsuit from being filed later.
Dismissal without Prejudice - allows a later filing.
District Court - in civil cases, judges hear cases for all actions involving $10,000 or less. District Court also has preliminary jurisdiction over felony cases and over the trial of all misdemeanors and infractions. This court also has exclusive jurisdiction over all juvenile proceedings, mental health hospital commitments and domestic relations cases. The state has 235 District Court judges who are elected by the voters for a four-year term and serve in 39 districts.
Drug Treatment Courts - a court-based intervention program to ensure that chemically dependent offenders receive appropriate treatment and are held strictly accountable for their behavior. Offenders participate for a minimum of one year, appearing before a judge twice a month to report on their progress or setbacks. If the offender does not comply with the strict terms of the program, the judge may order jail time.
Evidence - documents, objects or testimony admitted in a trial to prove certain facts.
Foreign Language Interpreter Project - using grant funding, the Foreign Language Interpreter Project is certifying interpreters for the courts. Interpreters are trained to translate for the court word for word what a non-English speaking person is saying, not what the interpreter thinks the person is trying to say. This project sponsors seminars on the subject, looking for potential court interpreters. It also trains and certifies court interpreters.
Guardian ad Litem - a person appointed by the court to represent the interest of a minor or incompetent during the litigation.
Guardian ad Litem Program - when a child is thrust into the legal system because of abuse, neglect or dependency, a trained GAL volunteer researches the child's home and community situation. That volunteer acts as the child's advocate in court, giving a judge information on the child's situation and making recommendations for the child's best interests including a safe, permanent home. More than 3,600 volunteers represent 12,000 children in every county across the state.
Hung Jury - one whose members cannot reach a verdict because of differences of opinion.
In Camera - in a judge's chambers, outside the presence of a jury and the public.
Injunction - a court order preventing one or more specific parties from taking some action. A preliminary injunction often is issued to allow fact-finding so a judge can determine whether a permanent injunction is justified.
Judge or Justice - a public official who hears and decides cases brought before a court of law. North Carolina has seven justices on the Supreme Court, 15 judges on the Court of Appeals, 105 Superior Court judges, and 235 District Court judges.
Judgment - the decision of a judge or jury resolving a dispute and determining the rights and obligations of the parties.
Judicial Branch - one of the three co-equal branches of government. The Legislative Branch enacts laws, the Executive Branch enforces laws, and the Judicial Branch interprets and applies laws in specific cases.
Jurisdiction - the power and authority of the court to hear certain cases. For example, the jurisdiction for divorce cases is in civil court.
Lien - a legal claim usually against a piece of land for payment of some debt, obligation, or duty. Some forms of liens are tax liens and materialman's liens.
Litigation - a controversy in a court.
Mediated Settlement Conferences - a statewide program dealing with civil Superior Court cases. When parties are in litigation, a mediator helps them arrive at mutually agreeable solutions. The state has nearly 900 certified mediators who conduct mediated settlement conferences. More than half of the cases are settled in this way.
Moot - not subject to a court ruling because the controversy has not actually arisen, or has ended.
Motion - A document filed with the court seeking to obtain a ruling or order from the court that is favorable to the party filing a motion.
Notice - a formal, written announcement communicating scheduling information or other information about a case. The original notice is filed with the clerk of Superior Court and copies are mailed or hand-delivered to parties to the litigation.
Party - the plaintiff or defendant in a case. The plaintiff is the party who files the lawsuit and the defendant is the party who is being sued.
Plaintiff - the one who initially brings a suit.
Preliminary Hearings - held to determine if there is sufficient evidence to hold a trial.
Preponderance of Evidence - evidence as a whole which shows the fact is more likely than not.
Reasonable Doubt - doubt based on reason, arising from evidence or lack of evidence.
Statute of Limitations - the time within which a lawsuit must be filed. The deadline can vary, depending on the type of lawsuit.
Supreme Court - the seven-member Supreme Court is the state's highest court. Justices decide questions of law in civil and criminal cases on appeal. The Supreme Court has the power to control and supervise the proceedings of other courts and has the authority to set court schedules and promulgate rules of practice and procedure for the trial courts. Voters elect the chief justice and the six associate justices of the Supreme Court for eight-year terms.
Tort - A civil, not criminal, wrong. An injury against a person or property.
Trial Court Administrators - North Carolina has 13 trial court administrators serving in 14 of the state's 46 Superior Court districts. They assist in managing the day-to-day administrative operations of the trial courts, including civil case calendaring, jury use, and maintaining local court rules.
Venue - The particular county in which the court with jurisdiction may hear the case for example, a divorce action is filed in civil court in the county where either the plaintiff or defendant resides).
Voir Dire - Jury selection process of questioning prospective jurors.
US Case Law
Federal Law Documents
United States statutes, case law, and documents relating to the US Social Security Act, Medicaid and the 1915(b)(c) federally funded Waiver programs, as well as Disability rights (in reverse chronological order), available for .pdf download.
Federal NC Lawsuits
Federal NC Lawsuits
- Order by Federal Justice Louise Flanagan issuing Preliminary Injunction re: Disability Rights NC: LS et al. v. Secretary Delia, in his official capacity as Secretary of the Department of Health and Human Services; Pamela Shipman, in her official capacity as Area Director of Piedmont Behavioral Health Care Area MHDDSAS Authority; and Piedmont Behavioral Healthcare area MHDDSAS Authority d/b/a PBH, [5:11-CV-00354-FL], issued March 29, 2012.
- Disability Rights NC: KC et al v. Secretary Cansler et al.; Plaintiffs' Memorandum in Support of Motion for Leave to File Supplemental Declaration in Support of Motions for Preliminary Injunction and Class Certification, [5:11-CV-00354-FL], filed March 2, 2012.
- Disability Rights NC Class Action Complaint: KC et al v. Secretary Cansler, in his official capacity as Secretary of the NC Department of Health and Human Services, Pamela Shipman, in her official capacity as Area Director of Piedmont Behavioral Health Care Area MHDDSA Authority, and Piedmont Behavioral Healthcare Area MHDDSA Authority d/b/a PBH, [5:11-CV-00354-FL], filed July 1, 2011.
- Disability Rights NC Class Action Complaint: Pashby et al. v. Secretary Cansler, in his official capacity as Secretary of the NC Department of Health and Human Services [5:11-CV-00273-BO], Filed May 31, 2011.
Report from the US Justice Department re: NC
- United States' Investigation of the North Carolina Mental Health System Pursuant to the American's with Disabilities Act, US Justice Department (Civil Rights Division), report from US Assistant Attorney General, Thomas E. Perez, to NC Attorney General Roy Cooper, finding the State of NC in violation of Title II of the ADA and putting the State on notice for failure to comply and of the minimum steps required for the State to meet its obligations under the law; July 28, 2011.
Americans with Disabilities Act (ADA)
Social Security Act and the 1915(b)(c) Waiver
- Title 42. The Public Health and Welfare, Chapter 7. Social Security Act, Title XIX. Grants to States for Medical Assistance Programs [USCS § 1396n], Current thru PL 112-90; approved January 3, 2012.
- Title 42. The Public Health and Welfare. Chapter 144. Developmental Disabilities Assistance Bill of Rights; Programs for Individuals with Developmental Disabilities; General Provisions [42 USCS § 15002], Current through PL 112-90, approved January 3, 2012.
Federal Registers
Federal Lawsuits
- Federal Register, Vol. 76, No. 73 Proposed Rules re: DHHS and CMS / 1915(b)(c); April 15, 2011.
Federal Lawsuits
Olmstead
- US Supreme Court (No. 98-536) Tommy Olmstead, Commissioner, Georgia Department of Human Resources, et al., Petitioners v. L. C., By Jonathan Zimring, Guardian Dd Litem and Next Friend, et al. June 22, 1999, decided.
- Olmstead: Syllabus. June 22, 1999.
- Olmstead: Opinion of the Court. June 22, 1999.
- Olmstead: Concurrence of Justice Kennedy. June 22, 1999.
- Olmstead: Concurrence of Justice Stevens. June 22, 1999.
- Olmstead: Justices Thomas and Scalia, Dissenting. June 22, 1999.
... more to come ...
08 March 2012
letter from DHHS Director Steve Jordan
March 8, 2012
Response via USPS:
Response via USPS:
From NC DHHS MHDDSAS Director Steve Jordan on behalf of Governor Beverly Perdue regarding my letter to the Governor dated 02/23.
*To date, I understand that Governor Perdue has not personally read my letter.
06 March 2012
email from Dr. Pat Porter
March 6, 2012
Response via email:
From: Dr. Patricia Porter, UNC adjunct Professor / DD and Policy Expert / hired Consultant to the NC General Assembly:
Hello Ms. De la Cruz-Hopper,
It was a pleasure to speak with you last week. As you know, Senator Hartsell and Representative Dollar asked that I contact you in response to the letter you sent to Governor Perdue and copied to members of the General Assembly. They were impressed with the comprehensiveness of your representation of your daughter’s status and the struggles you have had assuring that she receives the services and supports she needs as well as your concerns about issues that you have heard and read that may come from changes related to the statewide implementation of the Medicaid B-C Managed Care Waiver. You surely have done your homework and I believe you have done your best to become well informed about the changes to come in our MH-DD and SA system of services.
As you noted at the end of our conversation, there is a good bit of misinformation coming out about these planned changes and in some instances, an absence of factual information for families. As your own LME ( Wake) proceeds to prepare for the transition from a fee-for-services to a managed care operation, you are wise to make sure that you are being made aware of these plans and the potential impact of the changes. I understand that information and discussion opportunities are being planned and there is a request for questions currently posted on the Wake website. http://www.wakegov.com/humanservices/waiver/questions.htm
You may know that the session law (attached) directing the statewide expansion of the B-C Waiver has a number of specific provisions that require both the Department of Health and Human Services and the Local Management Entities to assure that the system is structured so that stakeholders, such as yourself, have meaningful knowledge of and input into the development of the new operation now and as it is established. LMEs have been conducting meetings with those receiving services and those currently providing services to discuss the changes and I hope you have been able to participate in those and in subsequent such meetings. Some of these forums have been conducted by the Jordan Institute for Families of the University of North Carolina School of Social Work under the direction of Professor Gary Nelson with a particular focus on the outcomes we hope to achieve with this system as they effect persons with disabilities and their families. The Department of Health and Human Services has recently established a Waiver Advisory Council http://www.ncdhhs.gov/mhddsas/providers/1915bcWaiver/index.htm comprised of stakeholders for the purpose of obtaining advice and council on the development of this new system. These meetings are open to the public and I would encourage you to attend and participate. There is an abundance of information about the B-C Waiver implementation on this website and you may want to take a look at the Strategic Plan listed there.
As we discussed, this is a significant change for the state of NC but a change that was deemed necessary by both the Department of Health and Human Services and by vote of the NC General Assembly. Transitions of this kind are necessarily disconcerting. While it is understandable that many individuals who have received services in the current system and some who have delivered those services would like the system to continue under its present structure, the decision was made that this is just not feasible. There are long waiting lists for service, some providers have not been of highest quality , some individuals and families have had to endure a revolving door of service providers with no reliability or consistency in service delivery, research has demonstrated that there is currently no relationship to the intensity of need of those who receive services and the services they receive. Some with relatively low need receive the highest cost services while many with very high need receive no services at all. In these lean budget times and with the pending changes in federal health care set to go into place in 2014, it is critical for the General Assembly, in concert with the DHHS and stakeholders to develop an accessible system that is of highest quality, responsive to the needs of people with IDD, MI, SA and their families and well managed to assure that both federal and state dollars are fairly and equitably allocated to the best benefit of the diverse population in need of services. Accountability is built in at every step with both internal and external evaluation of both program outcomes and expenditures. The General Assembly is committed to the development of this system with the meaningful input of individuals with disabilities and their families and with a foundation in evidence based outcomes. Your input and that of other key stakeholders is vital in assuring that the system achieves these intended goals.
I hope I was helpful as I answered your specific questions about the implementation of the B-C Waiver and its potential impact on services for your daughter and other people with IDD in our state. You suggested that you would like to develop a list of additional questions that we could discuss in a face-to-face meeting and I am happy to do that. Please let me know when you would like to schedule that meeting.
I look forward to speaking with you again.
Pat Porter
Patricia Porter, PhD, Consultant
From: Dr. Patricia Porter, UNC adjunct Professor / DD and Policy Expert / hired Consultant to the NC General Assembly:
Hello Ms. De la Cruz-Hopper,
It was a pleasure to speak with you last week. As you know, Senator Hartsell and Representative Dollar asked that I contact you in response to the letter you sent to Governor Perdue and copied to members of the General Assembly. They were impressed with the comprehensiveness of your representation of your daughter’s status and the struggles you have had assuring that she receives the services and supports she needs as well as your concerns about issues that you have heard and read that may come from changes related to the statewide implementation of the Medicaid B-C Managed Care Waiver. You surely have done your homework and I believe you have done your best to become well informed about the changes to come in our MH-DD and SA system of services.
As you noted at the end of our conversation, there is a good bit of misinformation coming out about these planned changes and in some instances, an absence of factual information for families. As your own LME ( Wake) proceeds to prepare for the transition from a fee-for-services to a managed care operation, you are wise to make sure that you are being made aware of these plans and the potential impact of the changes. I understand that information and discussion opportunities are being planned and there is a request for questions currently posted on the Wake website. http://www.wakegov.com/humanservices/waiver/questions.htm
You may know that the session law (attached) directing the statewide expansion of the B-C Waiver has a number of specific provisions that require both the Department of Health and Human Services and the Local Management Entities to assure that the system is structured so that stakeholders, such as yourself, have meaningful knowledge of and input into the development of the new operation now and as it is established. LMEs have been conducting meetings with those receiving services and those currently providing services to discuss the changes and I hope you have been able to participate in those and in subsequent such meetings. Some of these forums have been conducted by the Jordan Institute for Families of the University of North Carolina School of Social Work under the direction of Professor Gary Nelson with a particular focus on the outcomes we hope to achieve with this system as they effect persons with disabilities and their families. The Department of Health and Human Services has recently established a Waiver Advisory Council http://www.ncdhhs.gov/mhddsas/providers/1915bcWaiver/index.htm comprised of stakeholders for the purpose of obtaining advice and council on the development of this new system. These meetings are open to the public and I would encourage you to attend and participate. There is an abundance of information about the B-C Waiver implementation on this website and you may want to take a look at the Strategic Plan listed there.
As we discussed, this is a significant change for the state of NC but a change that was deemed necessary by both the Department of Health and Human Services and by vote of the NC General Assembly. Transitions of this kind are necessarily disconcerting. While it is understandable that many individuals who have received services in the current system and some who have delivered those services would like the system to continue under its present structure, the decision was made that this is just not feasible. There are long waiting lists for service, some providers have not been of highest quality , some individuals and families have had to endure a revolving door of service providers with no reliability or consistency in service delivery, research has demonstrated that there is currently no relationship to the intensity of need of those who receive services and the services they receive. Some with relatively low need receive the highest cost services while many with very high need receive no services at all. In these lean budget times and with the pending changes in federal health care set to go into place in 2014, it is critical for the General Assembly, in concert with the DHHS and stakeholders to develop an accessible system that is of highest quality, responsive to the needs of people with IDD, MI, SA and their families and well managed to assure that both federal and state dollars are fairly and equitably allocated to the best benefit of the diverse population in need of services. Accountability is built in at every step with both internal and external evaluation of both program outcomes and expenditures. The General Assembly is committed to the development of this system with the meaningful input of individuals with disabilities and their families and with a foundation in evidence based outcomes. Your input and that of other key stakeholders is vital in assuring that the system achieves these intended goals.
I hope I was helpful as I answered your specific questions about the implementation of the B-C Waiver and its potential impact on services for your daughter and other people with IDD in our state. You suggested that you would like to develop a list of additional questions that we could discuss in a face-to-face meeting and I am happy to do that. Please let me know when you would like to schedule that meeting.
I look forward to speaking with you again.
Pat Porter
Patricia Porter, PhD, Consultant
Health and Human Services
North Carolina General Assembly
301-B Legislative Office Building
300 N. Salisbury Street
Raleigh, NC 27603
(919) 301-1982
301-B Legislative Office Building
300 N. Salisbury Street
Raleigh, NC 27603
(919) 301-1982
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