NCGA DHHS-JLOC Meeting, 12/11

NORTH CAROLINA GENERAL ASSEMBLY Raleigh, North Carolina 27601

November 30, 2012

MEMORANDUM

TO: Members, Joint Legislative Oversight Committee- Health and Human Services FROM: Senator Louis Pate Representative Nelson Dollar, Co-Chair Representative Justin Burr, Co-Chair SUBJECT: Meeting Notice DAY DATE TIME ROOM Tuesday December 11, 2012 10:00 am 3:00   pm 643

If you are unable to attend or have any questions concerning this meeting, please contact Candace Slate at (919) 715-0795, Dina Long  (919) 733-5908, or Joey Stansbury (919) 733-7659.    cc:  Committee Record  _X_        Interested Parties    _X_

NCGA 10/16 HHS-JLOC Meeting Notice

NORTH CAROLINA GENERAL ASSEMBLY

Raleigh, North Carolina 27601

October 5, 2012

MEMORANDUM

TO: Members, Joint Legislative Oversight Committee - Health and Human Services

FROM: Senator Louis Pate, Co-Chair
Representative Justin Burr, Co-Chair
Representative Nelson Dollar, Co-Chair

SUBJECT: Meeting Notice

DAY Tuesday
DATE October 16, 2012
TIME 10:00 am - 3:00 pm
ROOM 643

If you are unable to attend or have any questions concerning this meeting, please contact Candace Slate at (919) 715-0795, Dina Long (919) 733-5908, or Joey Stansbury (919) 733-7659.

cc: Committee Record _X_
Interested Parties _X_

NCGA JLOC-HHS Meeting Agenda 9/10

SUBCOMMITTEE ON MENTAL HEALTH

JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON HEALTH AND HUMAN SERVICES

AGENDA

September 10, 2012, 1:00 P.M.,

Room 643, Legislative Office Building

Representative Justin Burr, Co-Chair

Senator Louis Pate, Co-Chair

Introductions and Comments 1:00-1:10
Chairman Burr
Chairman Pate

Review of Law Establishing Subcommittee Charge 1:10-1:15
FRD Staff

Overview of Major Mental Health Reform 1:15-2:00

• Major Legislative and Policy Changes 2001 – Present
  Research Staff

(Presentation will address major changes in the State’s delivery of mental health services, including information on Olmstead/ADA – description, impact on the state’s mental health system)

• Impact on State Facilities’ and Community Psychiatric Hospitals 2:00 – 2:45
  Ms. Laura White, Team Leader Psychiatric Hospitals
  Division of State Operated Healthcare Facilities

(Presentation will address number of people released into the community as a result of reforms/policy changes, adequacy of beds and services; changes in availability of state facility and community mental health beds over this period; state facility and community mental health bed capacity; state facility catchment areas)

• LME Perspective on Impact of Major Reform/Policy Changes 2:45 – 3:30
  Pam Shipman, CEO PBH

Impact of Mental Health Policy on Law Enforcement 3:15 – 3:30
Eddie Caldwell, Executive Director, NC Sherriff’s Association

Committee Discussion/Comments 3:30-4:00

Adjourn

NCGA JLOC-HHS Meeting Notice 9/11

NORTH CAROLINA GENERAL ASSEMBLY

Raleigh, North Carolina 27601

August 27, 2012

MEMORANDUM

TO: Members, Joint Legislative Oversight Committee-Health and Human Services

FROM: Senator Louis Pate, Co-Chair
Representative Justin Burr, Co-Chair
Representative Nelson Dollar, Co-Chair

SUBJECT: Meeting Notice

DAY: Tuesday
DATE: September 11, 2012
TIME: 10:00 am - 3:00 pm
ROOM: 643

NOTE: For scheduling purposes future meetings dates are as follows:

October 9, 2012
November 13, 2012
December 11, 2012
January 8, 2013

If you are unable to attend or have any questions concerning this meeting, please contact Rennie Hobby at 733-5639 or mentalhealthca@ncleg.net.

cc: Committee Record _X_
Interested Parties _X_

NCGA JLOC on HHS Committee Meeting 8/14

NORTH CAROLINA GENERAL ASSEMBLY

Raleigh, North Carolina 27601

July 31, 2012

MEMORANDUM

TO: Members, Joint Legislative Oversight Committee-Health and Human Services

FROM: Senator Louis Pate, Co-Chair
Representative Justin Burr, Co-Chair
Representative Nelson Dollar, Co-Chair

SUBJECT: Meeting Notice

DAY:  Tuesday
DATE:  August 14, 2012
TIME:  10:00 am - 3:00 pm
ROOM:  643

If you are unable to attend or have any questions concerning this meeting, please contact Rennie Hobby at 733-5639.

cc:   Committee Record _X_
       Interested Parties _X_

Parent Legislative Correspondence re PBH Executive Salary & Staff Council

Pat Wiegand is the parent caregiver of two adult DD recipients, Casey and Jason, who depend upon CAP Waiver supports to keep her family together and maintain some small level of community involvement.

You may recognize their names from their May 22nd Arc video at the Coalition Rally or from the touching Family Stories video earlier this year.

Pat and her family reside in Senate District 9 and House District 18. Her children, Casey and Jason, receive services through Southeastern Regional MH/DD/SAS Services (SRMHC) LME.

Parent Legislative Correspondence

> -----Original Message-----
> From: Pat Wiegand
> Sent: Monday, June 18, 2012 5:18 PM
> To: Sen. Stan Bingham; Sen. Harris Blake; Sen. Louis Pate; Sen. Chris Carney; Sen. Austin Allran; > Sen. Bob Atwater; Sen. Doug Berger; Sen. Jim Davis; Sen. Ellie Kinnaird; Sen. Eric Mansfield; 
> Sen. Wesley Meredith; Rep. William Brisson; Rep. Bill Current; Sen. Bill Rabon; 
> Sen. Gladys Robinson; Sen. David Rouzer; Sen. Bob Rucho; Sen. Tommy Tucker
> Subject:
>
> I would like you all to know me and mine all oppose any changes to state
> general statue 122C!
>
> In recent days I have learned that PBH ceo is earning 160.000 a year
> which I bet does not include bonuses. Plus they have 10 Attorneys on
> staff. Please tell me is this any way to spend money intended to help
> the disabled. As a family member I must say this is very upsetting
> .. I would think all citizens of North Carolina would be opposed to
> spending taxpayer money to a private company who is obviously making a
> good deal off our most needy. I have a thought has anyone considered
> doing managed care with a not for profit agency?
> It's just a thought
>
> Pat Wiegand

Parent Legislative Correspondence

Mary K. Short is a strong advocate and the parent caregiver of an adult DD recipient with profound needs.


Mary and her daughter live in NC House District 88 and Senate District 42. Her daughter is being served by Smoky Mountain LME.

Legislative Correspondence 

from another Parent Perspective

Mon, May 21, 2012 at 1:49 PM
From: MaryKShort@aol.com
To: Senator Louis Pate <louis.pate@ncleg.net>, 
Representative Justin P. Burr <justin.burr@ncleg.net>, 
Representative Nelson Dollar <nelson.dollar@ncleg.net>, 
Representative Martha Alexander <martha.alexander@ncleg.net>, 
Representative William D. Brisson <william.brisson@ncleg.net>, 
Representative William A. Current, Sr. <bill.current@ncleg.net>,  
Representative Mark W. Hollo <mark.hollo@ncleg.net>,  
Representative Pat B. Hurley <pat.hurley@ncleg.net>, 
Representative Bert Jones <bert.jones@ncleg.net>,  
Representative Marian N. McLawhorn <marian.mclawhorn@ncleg.net>, 
Representative Tom Murry <tom.murry@ncleg.net>, 
Representative Fred F. Steen, II <fred.steen@ncleg.net>, 
Senator Austin M. Allran <austin.allran@ncleg.net>, 
Senator Doug Berger <doug.berger@ncleg.net>, 
Senator Stan Bingham <stan.bingham@ncleg.net>, 
Senator Harris Blake <harris.blake@ncleg.net>, 
Senator Jim Davis <jim.davis@ncleg.net>, 
Senator Fletcher L. Hartsell, Jr. <fletcher.hartsell@ncleg.net>, 
Senator Eric Mansfield <eric.mansfield@ncleg.net>, 
Senator Martin L. Nesbitt, Jr. <martin.nesbitt@ncleg.net>, 
Senator William R. Purcell <william.purcell@ncleg.net>, 
Senator Tommy Tucker <tommy.tucker@ncleg.net>, 
Senator Andrew C. Brock <andrew.brock@ncleg.net>, 
Senator Ralph Hise <ralph.hise@ncleg.net>, 
Joint Caucus Leader Marilyn Avila <marilyn.avila@ncleg.net>, 
Representative Rayne Brown <rayne.brown@ncleg.net>, 
Representative Tricia Ann Cotham <tricia.cotham@ncleg.net>, 
Representative Beverly M. Earle <beverly.earle@ncleg.net>, 
Representative Shirley B. Randleman <shirley.randleman@ncleg.net>, 
Representative Mitchell S. Setzer <mitchell.setzer@ncleg.net>, 
House Speaker Thom Tillis <Thom.Tilllis@ncleg.net>

Dear Speaker Tillis and Members of NCGA:

I have sent emails to DMA requesting the best practice documentation that was used to support the 40 hour Policy limit on parent/family that is in the NC Innovations Waiver, the CAP-IDD Waiver, and Clinical Policy 8M. At that same time, I requested the best practice documentation that was used to support the Home Supports (HS) service definition from the 2008 CAP-MR/DD Comprehensive Waiver. I have not received a response.

Here is what the State Strategic Plan for MHDDSAS 2010-2013, dated July 1, 2010, page 12 of 46 says:

"Evidence based practices are those that have been shown to be effective in multiple, scientifically conducted research studies, while best practices are accepted clinical practices that demonstrate success for the individuals served."

I have asked for that documentation because they are in direct conflict with one another.

In 2008, DMA said parents may only work a daily service, no limit on the number of days.

(Home Supports has a "direct contact hours" component attached. Using DMA guidelines for HS Level 2, 6.5 hours a day maximum, would require a parent to work 45.5 hours a week maximum for the past 3+ years AND the highest level, HS Level 5, 12.5 hours a day minimum, would require the parent to work 87.5 hours a week minimum.)

Then in 2011-12, DMA said we cannot work over 40 hours a week. This is only parents or family members who live with an individual, not any unrelated staff who comes into the home or any AFL or other Group Home worker. I did not ask for the best practice documentation that DMA has used to consistently support unrelated workers working more than 40 hours a week.

As I have been waiting for a response from DMA, I did find this information posted below to PBH's web site: "To date, there are no national practice guidelines for the I/DD population." (Link provided below.)

If that statement was true when published on PBH's web site on 09292011, then what are families to believe about any DMA best practices placed into any waiver, rule, policy, or procedure? If DMA suspects some sort of rampant abuse by parents (or other living with family member) performing services, then why haven't their internal monitoring controls exposed those abuses?

I am asking that you all intervene on behalf of the 1,091 (+/-) parents (or other living with family members) who have been providing Home Supports for the past 3+ years and STOP the implementation of the 40 hour policy once and for all. I am asking you to believe me when I tell you that NO family who has participated as a formal stakeholder has said to me at any time that they SUPPORT the 40 hour limit on parents/family members. In fact, I am consistently told by formal stakeholder family members or individuals, that they SUPPORT CHOICE by the individual and/or guardian.

Finally, I want you to consider the following two NC Innovations service plans:

(Home Supports changes to: PC = Personal Care / I-HSB = In-Home Skill Building)

After accounting for unpaid supports, if he/she needs less than 40 hours of PC/I-HSB, then he/she gets to choose to use his/her parent to perform all PC/I-HSB services.

After accounting for unpaid supports, if he/she needs more than 40 hours of PC/I-HSR, then he/she CANNOT choose to use his/her parent to perform all PC/I-HSB services or any number of hours over 40 hours.

Why is it that the individual with the least ability to adjust to change is forced to change?

Mary K. Short
828-632-5888 or 704-451-4144 (cell)

http://www.pbhcare.org/guidelinearticles.asp **(Reviewed/Updated 03/26/2012)**

http://www.pbhcare.org/pubdocs/upload/documents/intro%20to%20IDD.pdf (09292011)

Introduction to I/DD (Intellectual/Developmental Disabilities)
Practice Guidelines

To date, there are no national practice guidelines for the I/DD population. In response to this situation, PBH initiated the development of an I/DD workgroup to draft guidelines. The I/DD work group includes stakeholders such as clinicians, providers, and family members who worked on a variety of projects related to the development of Practice Guidelines for I/DD Population. While the Practice Guidelines developed by the I/DD Workgroup are not exhaustive, the intention is that the guidelines will give providers and families useful information that can facilitate the process of learning more about I/DD.

http://www.pbhcare.org/pubdocs/upload/documents/Best%20Practice%20Guidelines%2011%2006%2006.pdf (10202011)

Practice Guidelines In
Working with Individuals Who
Have Developmental Disabilities

Tassé, M.J., Havercamp, S.M., & Thompson, C. (2006). Practice Guidelines in Working with Individuals who have Developmental Disabilities. Concord, NC: PBH.

From page 107:

PBH is concerned about the impermanence of funding sources and services for individuals with developmental disabilities. We are committed to empowering consumers and their families by giving you the information, skills, and resources you need to identify and obtain the best available supports. In this way, we help you become less reliant on the service delivery system to achieve your goals.

NCGA JLOC on HHS 5/15 Meeting Agenda

Note for those unable to attend:

Interested stakeholders unable to attend the JLOC HHS meeting (or any other legislative meetings) in Raleigh, may listen in via live Audio Broadcast on the NCGA website. 

In the event you are unable to listen live, the audio recording, as well as agenda and supporting documents, reports, etc. for this meeting will be posted afterward on the JLOC HHS webpage.

Meeting Agenda:

JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON

HEALTH AND HUMAN SERVICES

AGENDA

May 15, 2012

8:30 A.M.; Room 643, Legislative Office Building
Senator Louis Pate, Co-Chair, Presiding      

Personal Care Services and Medicaid I-Waiver Status Update ......... 8:30-9:10
   Albert Delia, Acting Secretary, Department of Health and Human Services
   Tara Larson, Chief Clinical Operating Officer, Division of Medical Assistance

Overview of State County Special Assistance and In-Home Special Assistance  .........  9:10-9:35
   Suzanne Merrill, Adult Services Section Chief, Division of Aging and Adult Services
   Curtis Crouch, Section Chief, Cost Accounting/Financial Reporting, DHHS Controller's Office

Institutes of Mental Disease Status Update  .........  9:35-10:10
   Tara Larson, Chief Clinical Operating Officer, Division of Medical Assistance

US DOJ Investigation of Mental Health System Status Update  .........  10:10-10:55
   Emery Milliken, General Counsel, Department of Health and Human Services

Medicaid 1915 b/c Waiver Status Update  .........  10:55-11:30
   Kelly Crosbie, Chief, Behavioral Health Policy Section, Division of Medical Assistance

Report of the Sub-Committee on LME Governance ......... 11:30-11:55
   Representative Nelson Dollar, Subcommittee Chair

DHHS Requested Statutory Changes- Provisional Licensure  ......... 11:55-12:10
   Beth Melcher, Assistant Secretary for MH/DD/SAS Development

JLOC-HHS - Recommended Legislation to the 2012 Regular Session ......... 12:10-12:30
   Committee Chairs

Adjourn.