| Join Us in Washington to Make a Difference |
| Does what happens in Washington, D.C. really matter? Can you make a difference? You bet! Every day millions of Americans with intellectual and developmental disabilities are impacted by the public policy decisions – big and small -- made by their representatives in Congress. And each year, hundreds of advocates attend the Disability Policy Seminar in Washington, D.C. to learn more about and discuss the hottest topics in disability public policy. We invite you to join us April 15-17 for an opportunity to advance the grassroots movement for people with I/DD and make sure your elected officials know what’s important to you. Monday and Tuesday, April 15 and 16, are filled with informative in-depth sessions from disability policy experts and opportunities to network with others from your state. And, we’ll have a “newcomers” track with sessions designed for people who are new to federal public policy advocacy to answer questions and give you the background you need. Then the event culminates on Wednesday, April 27 with a breakfast on Capitol Hill before you personally meet with your elected representatives and make a case for their cause supported by information about the issues provided during the Seminar. Register now and book your room at the Grand Hyatt in downtown Washington D.C. for a special early registration rate at www.disabilitypolicyseminar. Hosted by: The Arc, United Cerebral Palsy (UCP), Association of University Centers on Disabilities (AUCD), American Association on Intellectual and Developmental Disabilities (AAIDD), National Association of Councils on Developmental Disabilities (NACDD), and Self-Advocates Becoming Empowered (SABE) Sponsored by: Autism Society and NADD, an association for persons with developmental disabilities and mental health needs |
29 January 2013
Registration Now Open for 2013 Disability Policy Seminar
The 2013 ASNC Annual Conference in Charlotte, NC
Please disregard the prior email regarding this Annual Conference. Please note the information below and direct any questions to Marty Kellogg. Her address is at the end of this email.
Thank you.
The 2013 ASNC Annual Conference in Charlotte is fast-approaching! …
This year’s Conference will be held earlier – February 8-9 at the Hilton University Place Hotel in Charlotte. This is a not-to-be-missed event highlighted by great speakers, a wealth of resource information, networking opportunities, and a special way for Chapters to connect with each other. The theme of this year’s Conference is Autism Grows Up. It will focus on preparing for adulthood and all that comes with it: family transitions, living and working in the community, and the goal of independence. Participants will also learn from teaching and behavioral experts on best practices, gain insights about raising girls on the spectrum, and share the lighter side of autism through humor.
Back by popular demand, we are hosting another Chapter Dinner on Friday evening. Invitations will be sent to you in early January, and we will have seating at the Dinner for you, a Co-leader, and Treasurer … or two alternates. We would love to have each Chapter represented, so start planning now!
We’ve had a number of questions regarding Chapter leader registration. Unfortunately, we do not have the funds to send Chapter leaders and Treasurers this year, but we are encouraging groups that can to utilize Chapter funds to send a Leader, Co-leader (if applicable), Treasurer or two substitute representatives from your leadership teams. If you choose to use Chapter funds, you will not register online. Instead, I’m attaching a registration form specifically for use by Chapter Leader(s), Treasurer or two representatives. Just complete one form per person and be sure to indicate your Chapter Name and number of days you’re attending, along with your meal choices. Send directly to me, and I will take care of debiting your Chapter account (no need for an additional Chapter Check Request). Hotel registration does need to be done separately online however.
If your Chapter is interested in offering Conference Scholarships for parents or teachers from your County, we encourage you to do so. Please register Scholarship recipients using the attached form as well. It would be best to send these forms in together and remember – For every five registrations, the 6th is free!
We also want to remind you of two other options for obtaining financial support to attend the Conference. You and others may want to look into applying for Jean Wolff-Rossi Participant Involvement Funds or look for funding through your CAP Personal Care Plan. More information on both of these options is available on the ASNC website or you can click on the following link:http://www.autismsociety-nc.
More to come later! Thanks all … and as always, email me with any questions.
Marty Kellogg
2013-14 DHHS Related Legislative Committee Membership and Full Appropriations
Senate Appropriations
/ Base Budget (FULL)
Details
- Meets Tuesdays, Wednesdays,
Thursdays at 8:30 a.m. in 643 LOB LB
- Bills in Committee: None
- Meeting notices via e-mail
Members
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Co-Chairman
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Co-Chairman
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Co-Chairman
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Members
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Sen. Tom Apodaca, Sen. Dan Blue,
Sen. Andrew C.
Brock, Sen. Don Davis,
Sen. Joel D.
M. Ford, Sen. Thom Goolsby, Sen. Kathy
Harrington, Sen. Brent Jackson, Sen. Clark
Jenkins, Sen. Martin L. Nesbitt, Jr., Sen. Earline W. Parmon, Sen. Louis
Pate, Sen. Bill Rabon, Sen. Bob Rucho,
Sen. Jerry W. Tillman, Sen. Tommy Tucker
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House Appropriations
(FULL)
Details
- No meeting schedule has been
set
- Bills in Committee: None
- Meeting
notices via e-mail
Members
The names highlighted
in yellow are new
members to the DHHS related Committees
Senate Appropriations
on Health and Human Services
Details
- Meets Tuesdays, Wednesdays,
Thursdays at 8:30 a.m. in 422 LOB LB
- Bills in Committee: None
- Meeting
notices via e-mail
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Co-Chairman
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Co-Chairman
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Members
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House Appropriations
Subcommittee on Health and Human Services
Details
- No meeting schedule has been
set
- Bills in Committee: None
- Meeting
notices via e-mail
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Chairman
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Chairman
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Vice Chairman
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Vice Chairman
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Vice Chairman
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Members
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Policy Committees
House Health and
Human Services
Details
- No meeting schedule has been
set
- Bills in Committee: None
- Meeting notices via e-mail
Members
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Chairman
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Chairman
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Vice Chairman
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Members
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Senate Health Care
Details
- Meets Wednesdays at 11:00
a.m. in 544 LOB LB
- Bills in Committee: None
- Meeting
notices via e-mail
Members
27 January 2013
Geraldo Rivera - The P&A System
The most effective advocates, says Bernard, former Willowbrook "inmate," are the parents and the consumers themselves because they know what they need and they know what they want.
Of course, that's assuming that the powers-that-be listen & give a hoot rather than having their opinions handed to them by the 'trained experts' who have never met my child nor yours... just sayin'.
Ongoing problems with NC's managed care transition, and how to address them
From The Arc of North Carolina
The Arc originally opposed the move to a managed care system and still has significant reservations about the design. However, the political reality is that managed care is here to stay, and The Arc is committed to ensuring that NC's managed care system effectively meets the needs of people with disabilities.
A year and a half after the initial move towards managed care, we are feeling the impact of the plan’s short-sighted design and hasty implementation. Across the state, many of the entities responsible for implementing the shift to managed care (generally referred to as LME/MCOs) are struggling to make the managed care transition and are behind schedule. The effects of these transition problems can be felt throughout North Carolina.
In Mecklenburg County, the state first found that MeckLINK, the LME/MCO responsible for MH/DD/SA services in the area, had not achieved the necessary milestones to switch to a managed care model by its February 1st deadline. The state then re-assigned the responsibility to implement the new managed care system in Mecklenburg to a LME/MCO already operating under the managed care system, Cardinal Innovations Behavioral Healthcare. This decision meant that millions of dollars of public money MeckLINK spent preparing for the new managed care system would be wasted, and Mecklenburg County would adopt the new managed care system several months later than planned.
On January 23, DHHS, now under the leadership of Governor McCrory’s administration, gave MeckLINK a new target date of March 1st, providing it meets its “readiness benchmarks.” This change occurred just eight days before Cardinal Innovations was to take over.
In the southeast corner of the state, Coastal Care, the LME/MCO responsible for MH/DD/SA services for 5 counties including New Hanover, will miss its deadline to convert to the new managed care system by February 1st. While this came to light recently and details are scarce, for whatever reason the LME/MCO is not prepared to switch to the managed care system on schedule, which will result in a significant loss in savings.
Large overruns and implementation controversies are nothing new to NC’s managed care transition. Starting in January 2011, Western Highlands Network, the LME/MCO that manages MH/DD/SA services in 8 counties in the western part of the state, ran a monthly deficit of over $500,000.
Not every LME/MCO has made headlines with its transition to managed care. Many have made the transition largely out of the limelight, but questions remain about their readiness and the effectiveness of current operations.
Obviously, there have been significant problems with North Carolina’s transition to a managed care system for MH/DD/SA services. Now is the time for state leaders to learn from these controversies and make reasoned decisions about the future of our system, and the people it serves.
The Arc believes problems with the state’s transition to managed care stem from an overzealous rush to find savings, rather than a thoughtful and deliberate approach to system design. The operationally arbitrary deadlines for management entities to convert to the managed care waiver are a key example. Converting to a managed care system is not easy- it is expensive and disruptive. We must be sure that LME/MCO’s are truly ready to begin before they turn the switch.
The struggles of LME/MCOs the state deemed ready to move forward to the new system, including Western Highlands Network, prove that the prior notion of what ‘ready’ means is insufficient and needs to be re-examined. Clearly, LME/MCOs must prepare business systems capable of dealing with the large volume of claims, payments, and calls they will receive. It is also important that they are prepared to implement any new services available under the managed care system, respond to people with disabilities and their families about their concerns, and have a well-trained provider network that understands the intricacies of the new system.
Our system’s focus should be on the needs of individuals it is meant to support and the providers working within the system, rather than dreams of short term savings. Getting it right the first time with a well-measured, steady approach will lead to efficiency, cost containment, and higher satisfaction among consumers, providers, and LME/MCOs.
The Arc believes we must adhere the following basic principles if we are to make this transition to Managed Care successful.
All interested parties, including The Arc, must be open to new ideas and approaches surrounding managed care. There is no dishonor in adjusting a plan to meet current circumstances. The needs of people with disabilities should dictate policy, not the established position or ego of any state agency, MCO/LME, private organization, or individual. A real partnership with stakeholders must be achieved if we are going to succeed.
Ongoing problems with NC's managed care transition, and how to address them
In mid-2011, the NC legislature passed a bill that would dramatically change the way the state of North Carolina provides services for people with developmental disabilities, mental illness, and substance abuse (MH/DD/SA) issues. The state would shift from a fee-for-service system to a managed care system.The Arc originally opposed the move to a managed care system and still has significant reservations about the design. However, the political reality is that managed care is here to stay, and The Arc is committed to ensuring that NC's managed care system effectively meets the needs of people with disabilities.
A year and a half after the initial move towards managed care, we are feeling the impact of the plan’s short-sighted design and hasty implementation. Across the state, many of the entities responsible for implementing the shift to managed care (generally referred to as LME/MCOs) are struggling to make the managed care transition and are behind schedule. The effects of these transition problems can be felt throughout North Carolina.
In Mecklenburg County, the state first found that MeckLINK, the LME/MCO responsible for MH/DD/SA services in the area, had not achieved the necessary milestones to switch to a managed care model by its February 1st deadline. The state then re-assigned the responsibility to implement the new managed care system in Mecklenburg to a LME/MCO already operating under the managed care system, Cardinal Innovations Behavioral Healthcare. This decision meant that millions of dollars of public money MeckLINK spent preparing for the new managed care system would be wasted, and Mecklenburg County would adopt the new managed care system several months later than planned.
On January 23, DHHS, now under the leadership of Governor McCrory’s administration, gave MeckLINK a new target date of March 1st, providing it meets its “readiness benchmarks.” This change occurred just eight days before Cardinal Innovations was to take over.
In the southeast corner of the state, Coastal Care, the LME/MCO responsible for MH/DD/SA services for 5 counties including New Hanover, will miss its deadline to convert to the new managed care system by February 1st. While this came to light recently and details are scarce, for whatever reason the LME/MCO is not prepared to switch to the managed care system on schedule, which will result in a significant loss in savings.
Large overruns and implementation controversies are nothing new to NC’s managed care transition. Starting in January 2011, Western Highlands Network, the LME/MCO that manages MH/DD/SA services in 8 counties in the western part of the state, ran a monthly deficit of over $500,000.
Not every LME/MCO has made headlines with its transition to managed care. Many have made the transition largely out of the limelight, but questions remain about their readiness and the effectiveness of current operations.
Obviously, there have been significant problems with North Carolina’s transition to a managed care system for MH/DD/SA services. Now is the time for state leaders to learn from these controversies and make reasoned decisions about the future of our system, and the people it serves.
The Arc believes problems with the state’s transition to managed care stem from an overzealous rush to find savings, rather than a thoughtful and deliberate approach to system design. The operationally arbitrary deadlines for management entities to convert to the managed care waiver are a key example. Converting to a managed care system is not easy- it is expensive and disruptive. We must be sure that LME/MCO’s are truly ready to begin before they turn the switch.
The struggles of LME/MCOs the state deemed ready to move forward to the new system, including Western Highlands Network, prove that the prior notion of what ‘ready’ means is insufficient and needs to be re-examined. Clearly, LME/MCOs must prepare business systems capable of dealing with the large volume of claims, payments, and calls they will receive. It is also important that they are prepared to implement any new services available under the managed care system, respond to people with disabilities and their families about their concerns, and have a well-trained provider network that understands the intricacies of the new system.
Our system’s focus should be on the needs of individuals it is meant to support and the providers working within the system, rather than dreams of short term savings. Getting it right the first time with a well-measured, steady approach will lead to efficiency, cost containment, and higher satisfaction among consumers, providers, and LME/MCOs.
The Arc believes we must adhere the following basic principles if we are to make this transition to Managed Care successful.
Stability for individuals served and those who provide the services must be the highest transition priority. No LME/MCO should be allowed to shift to managed care if they are not ready. It should be clear that readiness means the ability to successfully support people with disabilities.
Decisions about LME/MCO mergers and “assignments” need to be about competency and not about politics.
Where competing goals exist, the state needs to be clear about which it values more. For example, ‘local public management and ‘administrative efficiencies’ are not always mutually exclusive, but in certain areas they may be.
All interested parties, including The Arc, must be open to new ideas and approaches surrounding managed care. There is no dishonor in adjusting a plan to meet current circumstances. The needs of people with disabilities should dictate policy, not the established position or ego of any state agency, MCO/LME, private organization, or individual. A real partnership with stakeholders must be achieved if we are going to succeed.
Finding savings within state systems for people with disabilities is certainly laudable, but if the savings mean sacrificing the ability of the system to perform its mission, then they are counter-productive. As the saying goes, buy it right or buy it twice.
Comments
MCO's
We who are involved in all the changes sit back and watch and read all that is occuring. We hear that different MCO's get different PMPM amounts and do not understand why. We hear that LME's can not get it together in the outlined time frame. We watch and read about Western Highlands being half a million dollars in the red for months while the board did not realize it. We hear and wonder how MCO's like Western Highlands have the monies to hire agencies like the private group they hired at the cost of hundreds of thousands of dollars to tell them what they are doing wrong after this State hired Mercer to tell them that and still the Mercer organization is at Western Highlands looking at what they are or are not doing right over a year after they began operating while the private agency is there. Now we hear of Mercer going into other LME's to see if they are ready. Why? We watch Western Highlands fire their CEO and pay an agency thousands of dollars to locate a new CEO. We hear agencies not getting reimbursed in a timely manner over never ending changing requirements. We have watched as agency, therapists and psychiatrist have left Western Highlands and I am sure this is the same for other MCO's and wonder where this State is in thinking of the Best Interest of the individuals that they are to serve while spending monies on things that should have already been in place. What is wrong with this picture? Does anyone wonder why all these monies are being spent on requirements that were supposed to be in place instead of on the individuals that they are to serve. I have not heard of any direct care staff which are the back bone of all this getting anything extra for all their efforts. We are forgetting the reason all these MCO's were started, the individuals that they are Supposed to Serve.
Southeastern NC LME "Coastal Care" will not implement the 1915(b)(c) waiver on Feb. 1
Announcement made via One sentence memo on website
Coastal Care will not be implementing the 1915(b)(c) managed care waiver by February 1. The organization made the announcement through a brief communications memo posted to it's website January 22, 2013.
Coastal Care will not be implementing the 1915(b)(c) managed care waiver by February 1. The organization made the announcement through a brief communications memo posted to it's website January 22, 2013.
At this time, we have no additional information, but will share updates as they become available.
CoastalCare is a local government public agency that provides management and oversight of mental health, intellectual/developmental disabilities, and substance abuse services through a provider network for the residents of Brunswick, Carteret, New Hanover, Onslow, and Pender counties.
An Update on the Personal Care Services/ Group Home Crisis
From the Arc of NC
An Update on the Personal Care Services/ Group Home Crisis
In late December, many people with disabilities who had been receiving Personal Care Services (PCS) began receiving letters from the NC Division of Medical Assistance stating they did not qualify under newly implemented guidelines. This includes the vast majority of those who had received PCS and lived in group homes. The Arc of North Carolina and other organizations advised these people to appeal their denials. While most of these appeals are expected to be denied, those appealing will be able to continue receiving PCS until the appeals process is exhausted.
The NC legislature had hoped the state appeals process would drag out due to the large number of appeals, effectively buying time to put together a short term fix for the PCS crisis. So far we are not seeing that happen. This month we have received reports from across the state that the Medicaid appeals process is in full swing. There have been multiple reports of mediation calls and meetings for those individuals who appealed their PCS denial. Mediation is just the first step of the appeals process, but the rapid speed at which the legal process is moving is a surprise to many.
This means the “short term” fix of changing the special provision on the $39 million for PCS to include those living in group homes needs to happen as soon as the legislative session begins in earnest on January 30.
Governor Perdue had reserved $1 million to provide emergency funds in place for those who were denied PCS. However, that safety net is set to expire on January 31, 2013- one day after the new legislative session starts in earnest.
The clock is ticking and we are still facing a crisis. Many of those who no longer qualify for PCS live in group homes and potentially face homelessness. We urge legislative leaders to act quickly to avoid placing further undue hardship on people with disabilities affected by this crisis.
An Update on the Personal Care Services/ Group Home Crisis
In late December, many people with disabilities who had been receiving Personal Care Services (PCS) began receiving letters from the NC Division of Medical Assistance stating they did not qualify under newly implemented guidelines. This includes the vast majority of those who had received PCS and lived in group homes. The Arc of North Carolina and other organizations advised these people to appeal their denials. While most of these appeals are expected to be denied, those appealing will be able to continue receiving PCS until the appeals process is exhausted.
The NC legislature had hoped the state appeals process would drag out due to the large number of appeals, effectively buying time to put together a short term fix for the PCS crisis. So far we are not seeing that happen. This month we have received reports from across the state that the Medicaid appeals process is in full swing. There have been multiple reports of mediation calls and meetings for those individuals who appealed their PCS denial. Mediation is just the first step of the appeals process, but the rapid speed at which the legal process is moving is a surprise to many.
This means the “short term” fix of changing the special provision on the $39 million for PCS to include those living in group homes needs to happen as soon as the legislative session begins in earnest on January 30.
Governor Perdue had reserved $1 million to provide emergency funds in place for those who were denied PCS. However, that safety net is set to expire on January 31, 2013- one day after the new legislative session starts in earnest.
The clock is ticking and we are still facing a crisis. Many of those who no longer qualify for PCS live in group homes and potentially face homelessness. We urge legislative leaders to act quickly to avoid placing further undue hardship on people with disabilities affected by this crisis.
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