Showing posts with label NC HB 916. Show all posts
Showing posts with label NC HB 916. Show all posts

31 August 2012

What's New in August

August 2012 news, events, and updates.


30 June 2012

What's New in June?

June 2012 events and updates.

07 June 2012

Legislative Correspondence to Rep. Bill Current


Wed, May 30, 2012 at 3:51 PM
From: Crystal J. De la Cruz  


Dear Dr. Current,

My sincere apologies for the delay in following up after our May 15th visit. It was a great pleasure meeting you and getting to know a bit about you as a person; I'm so glad the time afforded us a chance to chit-chat. Both [name stricken] and I were moved by your deeply-rooted integrity and moral compass. I dare say the world could use more people like you Dr. Current and your family is very lucky to have you. 

I greatly appreciate your time and attention in meeting with [name stricken] and I regarding Medicaid Waiver concerns for the DD populations, their families and the wonderful providers who have kept us all afloat throughout this rocky journey. 

No, it's not an easy life raising a child with profound special needs - in fact, unimaginable to most, but I can tell you one thing with the utmost certainty: at the end of the day, it's our special folks who keep it real and truly put life in perspective. That is why I do what I do because I am the mother Isabel needs me to be. I firmly believe special people were not born to be tested, rather to serve as litmus to the rest of us. 

Several members have expressed that they haven't heard from many parents. I keep pointing out that it is not an easy feat for many of these folks to pack up their kids with all their meds, supplies, sensory items, and equipment and travel hours away for a 30 minute - an hour meeting and well, most don't have the time nor vacation time because they use it all going to appointments with doctors and specialists. Most of us do the very best we can with what we got and sometimes there's no extra left over. And sometimes when we do let the laundry or dishes go or forgo a shower to take the time to sit down and write a letter, send an email - pleading for help, it falls on deaf ears.

I am polishing up additional materials for you that I hope to send later today regarding our prior visit and conversation, though meanwhile I wanted to share with you the attached documents forwarded to me by fellow parent Mary K. Short who finally received them yesterday from Brad Dean at the DHHS Office of Public Affairs. These are the Public Comment response records from 2011 regarding the 8M CAP I/DD Clinical Policy proposals posted from 5/12 thru 6/26 and from 7/28 thru 8/11 -- a total of 540 comments; 618 pages. Pretty interesting reading. And this is what's missing.

Comments were made from across North Carolina by many parents and caregivers sharing heartfelt details of their lives as well as professionals, providers, and advocates in the DD field who know well the devastating impact such changes and service cuts would have not only on the recipients and families they serve and care for, but on their small businesses, their livelihood and the lives of staff they employ as well.

My sincerest hope that our elected officials - our Governor and members of the North Carolina Senate and House of Representatives - aspiring candidates, policy-makers, Health and Human Services administrators, LME's, MCO's, and other stakeholders and powers that be take the time now to hear that voice as our lives are in your hands... not merely the quality of our lives but rather our ability to live.

I know I'm asking a lot of you to sit down with a book like this but I also know you understand the importance of the messages inside. Thank you again for your time and attention and thank you in in advance for your considerations.

Kind regards,

-- 
Crystal J. De la Cruz - Hopper
Mother, Advocate & Concerned Citizen

When we allow the value of human life to be determined by capital gain, when we sacrifice the well-being of the most innocent among us to compensate our own shortcomings, and when we judge the worth of our most fragile, not by their character nor intention, but rather their abilities – We Are in Crisis.

http://no2nchb916.blogspot.com/

"The moral test of government is how it treats those who are in the dawn of life . . . the children; those who are in the twilight of life . . . the elderly; and those who are in the shadow of life . . . the sick . . . the needy . . . and the disabled." 
--Hubert H. Humphrey

2 attachments
20110512-0626 NC-DHHS-DMA Public Comments 8M CAPIDD.doc [598K]
20110728-0811 NC-DHHS-DMA Public Comments 8M CAPIDD.doc [2786K]

from CMS re Comprehensive & Supports Waivers

From: Connie.Martin@cms.hhs.gov
To: MaryKShort@aol.com
Sent: 6/6/2012 10:00:59 A.M. Eastern Daylight Time
Subj: RE: Follow-Up re CAP-IDD waiver

Dear Ms. Short,

The CAP-IDD waiver (a.k.a., NC 0662, Comprehensive waiver) is not yet approved. We continue to work with the State toward getting the waiver approved.

We are also working with the State to get the NC 0663, Supports waiver for MR/IDD individuals approved. NC 0663 has the same extension date as the Comprehensive waiver. As you probably already know, the Supports waiver provides services for those individuals who needs are less severe than the individuals in the Comprehensive waiver.

Thank you,
Connie

From: MaryKShort@aol.com [mailto:MaryKShort@aol.com]
Sent: Tuesday, June 05, 2012 6:39 PM
To: Martin, Connie L. (CMS/SC)
Subject: Follow-Up re CAP-IDD waiver

Hi Connie. Here it is the beginning of June and we are all wondering (AGAIN - not your fault that our DMA does not let anyone know anything) if the CAP-IDD waiver is approved? We all know there is an extension to 06.28.2012. Thank you.

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

NCGA 6/12 HHS Committee Meet & New Bills

NORTH CAROLINA HOUSE OF REPRESENTATIVES
COMMITTEE MEETING NOTICE
AND
BILL SPONSOR NOTIFICATION
2011-2012 SESSION

You are hereby notified that the Committee on Health and Human Services will meet as follows:

DAY & DATE: Tuesday, June 12, 2012
TIME: 10 :00 am
LOCATION: 544 LOB
COMMENTS: The following bills will be considered:
BILL NO. HB 975
SHORT TITLE: Promote Local/Healthy Food.
SPONSOR: Representative LaRoque, Representative Sanderson, Representative Insko 
BILL NO. HB 1098
SHORT TITLE: Continue the Sustainable Local Food Advisory.
SPONSOR: Representative Sanderson, Representative LaRoque 
BILL NO. SB 433
SHORT TITLE: Local Human Services Administration.
SPONSOR: Senator Hartsell 
BILL NO. SB 525
SHORT TITLE: Streamline Oversight/DHHS Service Providers.
SPONSOR: Senator Tucker, Senator Hartsell
Respectfully,
Representative Current, Chair
Representative Dollar, Chair
Representative Hollo, Chair

I hereby certify this notice was filed by the committee assistant at the following offices at 1 PM o’clock on June 07, 2011.

Principal Clerk
Reading Clerk – House Chamber

Wendy Miller (Committee Assistant)

05 June 2012

CMS Denies 7/1 CAP-IDD Waiver

From: tames@durhamcountync.gov
Sent: Tuesday, June 05, 2012 2:10 PM
Subject: June 21st CAP Waiver training

I just learned that the CAP I/DD Waiver that was to go into effect July 1st has not been approved by CMS. Therefore, another extension of the current waiver will be requested.

Due to this development, the CAP I/DD Waiver training scheduled during our June 21st TCM agency supervisor meeting has been cancelled until further notice.

Terry Ames
Intellectual and Development Disabilities Program Specialist
The Durham Center
919.560.7511-office 919.560.7250-fax
tames@durhamcountync.gov

Parent Perspective & Legislative Correspondence

Mary K. Short is a strong and active advocate and the parent caregiver of an adult DD recipient with profound needs. She fights tirelessly for the rights of her daughter, Katie and other special families, as well as a great deal of time keeping folks informed! Below is her mail to her parent list (in blue) which includes her 6/4 legislative correspondence regarding the 8M Clinical Coverage Policy proposals and Public Comments to DMA. Posted with Mary's permission.

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

Parent Perspectives 

and Legislative Correspondence

From:  Mary K. Short  June 5, 2012
Hello all. As I have been trying to stop the further implementation of the NC Innovations waiver, one of the things I have repeatedly told the Members of the NC General Assembly (NCGA) is that the Department and Divisions DO NOT LISTEN TO FAMILIES. One of the things that had been bothering me is the fact that "Proposed Clinical Policy 8M CAP-IDD" was never posted to the DMA web site as approved. You should recall that it was posted for public comments twice, for a 45-Day period (May 12, 2011 - June 26, 2011) and then again for a 15-Day period (July 28, 2011 - August 11, 2011). The 15-Day comment period was when Home Supports was eliminated! I submitted a Freedom Of Information Act request (FOIA) and after some delay by the Department and Divisions, I did actually receive the documents! They sent me Word file documents of ALL the public comment they received. The links below are to those documents. PLEASE BE AWARE THAT I HAVE NOT REMOVED ANY INFORMATION FROM THE PUBLIC COMMENT DOCUMENTS. They contain email addresses, addresses, phone numbers, WHATEVER was submitted is what was released. I have not edited the information in any way.

https://www.sugarsync.com/pf/D6195569_4698706_718588 (Part 1: 539 pages; 439 comments; 15 day comment period.)

https://www.sugarsync.com/pf/D6195569_4698706_718581 (Part 2: 79 pages; 101 comments; 45 day comment period.)

They are tremendously moving to read. I want to thank every single family who submitted comments. I want to add that MOST of the comments are NOT from people who are directly on my email list. I know some of you forward my emails, and so, I want to thank you for doing that. I don't care if the comments are from my email group or members of The Arc or UCP or Case Management providers or service providers, whoever, I am just thankful for the families who did comment. Except for two that I remember, they were in COMPLETE AND TOTAL OPPOSITION to the elimination of Home Supports, the implementation of a 40-hour policy, and opposed denying the use of Respite on the same day as Home Supports or Residential Supports.

After having all of it printed and READING EVERY SINGLE PAGE, I sent the following email:

From: MaryKShort@aol.com
To: Governor Beverly Perdue <governor.office@nc.gov>, 
Senate President Pro Tempore Phil Berger <Phil.Berger@ncleg.net>, 
House Speaker Thom Tillis <Thom.Tillis@ncleg.net>, 
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 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 McLawhorn <marian.mclawhorn@ncleg.net>, 
Representative Tom Murry <tom.murry@ncleg.net>,
Representative Fred F. Steen, II <fred.steen@ncleg.net, 
Senator Austin 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 Hartsell <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 A. 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>, 
Representative Tim Moffitt <tim.moffitt@ncleg.net>
CC: MaryKShort@aol.com
Sent: 6/4/2012 7:34:52 A.M. Eastern Daylight Time
Subj: Public Comments to 8M Clinical Policy - links provided

Dear Gov. Perdue, Sen. Berger, Speaker Tillis, and Members of the NCGA:

On 04072012 I sent a Public Records request to DHHS. I have no idea why there was a problem with getting it to the right person. That FOIA (Freedom Of Information Act) request was for ALL of the public comments that were submitted to DHHS/DMA for Proposed Clinical Policy 8M CAP-IDD. There were two comment periods. May 12 - June 26, 2011 (45 days) and July 28, 2011 - August 11, 2011 (15 days.)

In a phone call with Susan E. Johnson at DMA on 05082012, she told me she had compiled and sent that 8M public comment information to DHHS. (Additionally, on 05082012, I emailed her requesting the "best practice documentation" for the family as provider 40 hour policy. However, as of today, I still have NOT received the best practice documentation. I followed up with her on 05172012 and her reply on 05182012 was that she had asked DHHS to assist her.)

Brad Deen, DHHS, spoke with me at the MCAC (Medical Care Advisory Comm.) Meeting on 05182012 and told me he had sent the documents to a different Mary Short email address. I was confused by that since I had made the request in an email to begin with. I gave him the correct information and he said he would send it. When I had not received the information by 05292012, I tried email again. Two emails and a phone call later, I received the documents on 05292012. They are in Word. I have provided links to the documents rather than attaching them to this email.

https://www.sugarsync.com/pf/D6195569_4698706_718588 (Part 1: 539 pages; 439 comments; 15 day comment period.)

https://www.sugarsync.com/pf/D6195569_4698706_718581 (Part 2: 79 pages; 101 comments; 45 day comment period.)

When we were in Raleigh on 05302012 and 05312012, I had the documents on a thumb drive with me and I told as many legislators as I could about what was in the documents I had barely had a chance to read. Sen. Daniels' LA, Andy, downloaded the documents. I have sent them as email attachments to some other people, too. Additionally, I have sent them to the HHS/OCR attorney in Atlanta who has been assigned my (our) complaint because I specifically complained about 8M and that DHHS/DMA/DMH not listening to the comments.

On Friday, 06012012, I had both documents printed out. Over the weekend, 06022012-06032012, I did read every single page. There were two comments in favor of the proposed changes, both from LME/MCO's. Mothers, fathers, brothers, sisters, aunts, uncles, cousins, grandparents, or any other family relation you can imagine, all wrote to beg that DMA not change the CAP-IDD(MR/DD) waiver by eliminating Home Supports or limiting families to 40 hours a week. These are very, very compelling comments. Agencies, such as The Arc or UCP or ASNC (Autism), all wrote to oppose the elimination of Home Supports or to oppose the 40 hour limit. And yet, DMA did just that. You must be wondering, just as I am, why it is that if there are 1,091 +/- parents performing Home Supports in all of NC and 500 comments were received in opposition to the elimination of Home Supports or the 40 hour policy, then why would DMA do it? I sincerely believe it is because they are simply mean-spirited. There is no logical reason to believe otherwise.

I have spent time and effort in an attempt to convince you that there is a problem at DHHS/DMA/DMHDDSAS. I don't know what it is you need to have in your hands in order to believe me and in order to take any action to stop the further expansion of the 1915(b)(c) waivers and more specifically, the 1915(c) NC Innovations waiver. Please. The PBH pilot of the Innovations waiver INCLUDED its own HOME SUPPORTS service definition. It was just in July of 2011 that the NC Innovations waiver eliminated Home Supports and implemented a 40 hour policy. The NC Innovations waiver that is being expanded is NOT the Innovations waiver that was piloted by PBH all those years.

The fact the CMS has approved any State Plan or State Plan Amendment or Waiver is NOT proof that what DHHS/DMA/DMHDDSAS has done is legal. You all are acutely aware of the DOJ findings with regard to ACH/IMD and Personal Care Services. The fact that there is a pending lawsuit (K.C. v NCDHHS, PBH, et al.) brought against PBH after the changes to the piloted Innovations waiver is also proof of some level of disregard of the PEOPLE impacted by the Innovations waiver.

The financing of this waiver through a capitation formula which results in a month to month variable check to the LME/MCO's rather than an annual appropriation by the NCGA which always allowed for growth (moving people off of the wait list and into direct services) is flawed or a sham, or both!

The fact the MONEY has been spent by LME/MCO's on this expansion is not an argument to continue the expansion. Clearly, DHHS/DMA/DMHDDSAS has wasted millions of dollars in the past on policies or programs that have failed. Those live human beings in the IDD community are simply the least able to recover from another DHHS/DMA/DMHDDSAS "failed" policy.

Please stop the further expansion of the NC Innovations waiver. Thank you all, again.

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

I have not given up in any way. Because the public comments are public documents, you can forward the links to anyone you choose.

Finally, I want to address the issue of "our" information being public. I am sorry if any of you did not want your information released, but the DMA web site is very clear that the information that is given as a public comment can, in fact, be released as a public document. I am hopeful that all of us feel it is more URGENT and IMPORTANT to speak out against these changes, than to be silenced by the threat that our information may be made public. Of course, you can always sign up for a gmail or yahoo email account rather than using your "real" email account to send "public comment" from!

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

04 June 2012

Public & Parent Perspectives: Did You Hear Our Voice?

In case you missed the posting of DMA's Public Comments on the 8M Clinical Coverage Policy proposals in May and July of 2011, I'm posting again as I recently updated the post with additional files - namely the 2 different proposals which were posted for comment, a side-by-side comparison of the two proposals, and the 2010 8M Clinical Coverage Policy prior to the changes.

Here are the documents again:

NOTE: The 15-day posted proposal drastically differs from the 45-day posted proposal, with a total of 14 pages deleted from the second proposal posted.
PUBLIC COMMENTS on CAP-IDD CHANGES:
Comments were made from across North Carolina by many parents and caregivers sharing heartfelt details of their lives as well as professionals, providers, and advocates in the DD field who know well the devastating impact such changes and service cuts would have not only on the recipients and families they serve and care for, but on their small businesses, their livelihood and the lives of staff they employ as well.

It is our sincerest hope that our elected officials - our Governor and members of the North Carolina Senate and House of Representatives - aspiring candidates, policy-makers, Health and Human Services administrators, LME's, MCO's, and other stakeholders and powers that be take the time now to hear that voice as our lives are in your hands... not merely the quality of our lives but rather our ability to live.

Here's a synopsis / overview of the initial 8M Clinical Coverage Policy proposal posted for comment from May 12 - June 26 from special parent, Mary K. Short (Mary's comment in blue, the rest are quotes from the 8M). --Remember, the second proposal is less 14 pages.

There are a couple of things that caught my eye. The most important may be that they have proposed changing the respite policy so that you CANNOT use respite on a day you use Home Supports or are an AFL. I would hope you all contact your child's primary care physician and ask him/her to send in a comment to the DME web site in opposition of that proposal. Remember, the comments are reviewed by the PAG (Physician's Advisory Group) and I think your MD's comments are going to carry more weight than your comments. BUT you should send you comment, too! I have never understood where the "best practice" is that says respite cannot be regular and scheduled, so I certainly cannot understand where the "best practice" is that says the primary caregiver can't use four (4) hours of respite every Sunday so they can attend church services in order to pray for strength to continue fighting the battle against ridiculous proposed clinical policies!


The respite changes are throughout the document! However, in the list of Service Definitions, either Crisis Respite or Respite pretty much spells it out. Page 54 of the document or page 101 and then go to the "Service Limitation."


The next couple of things that caught my eye are outlined below. The first is this idea of "habilitative" and how it jumps in and out throughout the proposed clinical policy. The most disturbing loss of habilitation comes in the form of Residential Services to replace Residential Supports. The new Residential Services is NONHABILITATIVE and that would seem to signal the providers that they could now simply park an individual in front of a TV! I am sure it also signals a tremendous rate change coming to them. But somehow, AFL's, who are paid that service definition of Residential Services, is singled out as HABILITATIVE. Huh? And then that designation as HABILITATIVE for both AFL's and HOME SUPPORTS limits the individual to 129 hours of any combination of habilitative services (day supports, HCS, etc.), yet the Residential Services individual has a limit of 209 hours! That is a HUGE penalty for living in an AFL or in a family home ... or is it a HUGE incentive to move to a group home?

Bottom of page 2: ...

1.1.5 Habilitation Services
Habilitation services are those services designed to assist participants in acquiring, retaining, and improving the self-help, socialization and adaptive skills necessary to reside successfully in home- and community-based settings.

Bottom of page 10: ... this is eliminated:

Residential Supports is a habilitation service, with built-in Personal Care at a daily rate to meet the flexible daily needs of the individual. As a blended service, its range of hours for each NC-SNAP level of service (Level 1 through Level 4) includes both components—personal care and habilitation. This hour range
indicates the hours of direct contact service and support expected for each level of the service.

Top of page 11: ... and is replaced with this:

The service also provides assistance, support, supervision, and monitoring that supports individuals to participate in home or community activities. This service is not a habilitative service; however, the service shall be conducted in a manner that promotes and encourages independence

Page 12: Home Supports remains habilitative:

5.1.3 CAP-MR/DD CAP-I/DD Participants Receiving Home Supports 
Home Supports is provided only to adult participants who reside in their natural home with their parents (natural, adoptive or step parents) and other family members, where the parents (natural, adoptive or step parents) of the adult participant request to provide the Home Supports to the participant. Home Supports is a habilitation service, with built-in Personal Care at a daily rate to meet the flexible daily needs of the individual. As a blended service, its range of hours for each NC-SNAP level of service (Level 1 through Level 5) includes both components—personal care and habilitation. This hour range indicates the hours of direct contact services and support expected for each level of the service.

Page 14: The second paragraph says to focus on habilitation needs:

5.3.2 Person Centered Plan Reviews
At a minimum, the responsible professional (Targeted Case Manager) shall review the Person Centered Plan based upon the target date assigned to each goal, when the individual’s needs change, or when a service provider changes. For CAP-MR/DD CAP-I/DD participants, the Targeted Case Manager shall
review the Person Centered Plan every year prior to the individual’s birthday month.

The person-centered planning team shall focus on the habilitation needs of the
individual. Services that are habilitative in nature are not covered under the State
Plan except in an ICF-MR; however, they may be covered as a distinct waiver
service. In reviewing the Person Centered Plan, the Targeted Case Manager shall
include a review of the individual’s progress toward meeting goals identified on
the existing plan and document adjustments made as necessary.

Page 37: An AFL setting is habilitative:

Alternative Family Living
For the purposes of the CAP-MR/DD CAP-I/DD waiver, an Alternative Family Living (AFL) home or adult foster home is considered an out-of-home setting for a person who chooses this setting. The participant receives 24-hour care and lives in a private home environment with a family who are paid to provide services to address the care and habilitation needs of the participant. The family will continue to reside in this home if they choose to no longer provide supports and the participant moves from their home. The LME and targeted case manager are responsible for monitoring the health and safety of the participant. CAP-MR/DD CAP-I/DD funds may not be used for room and board costs.

Page 64: (Day Supports AND Home & Community Supports service limitations both have this service limit sentence about habilitation hours and residential setting.)

Service Limitations:
The maximum combined habilitation services limit is 129 hours per month for all habilitative services with the exception of individuals receiving Residential Services who may receive up to 204 hours per month for all habilitative services.

Page 75: (Home Supports is habilitative.)

K. Home Supports
Service Definition and Required Components:
The intent of this service is to meet the habilitation and personal care needs of adult participants (18 years or older) who choose to live with and receive supports from their families and whose families wish to provide services to the participant in their family homes. Home Supports is designed to provide flexibility and reflect the natural flow of the participant’s day. ...

... This service is distinctive in that it includes habilitation and training activities, as well as care and assistance with activities of daily living when the participant is dependent on others to ensure health and safety. ...

Bottom of page 77: (Underline indicates STRIKE OUT.) Utilization Management (UM) for Home Supports eliminates habilitation:

f. This service requires identification of goal directed progress
g. Habilitation requires goal related process on the Person Centered Plan

Page 85: (NO STRIKE OUT ?!) UM for Long Term Vocational Supports or Specialized Consultative Services or Supported Employment keeps habilitation:

f. This service requires identification of goal directed progress
g. Habilitation requires goal related process on the Person Centered Plan

Page 93: (COMPLETE STRIKE OUT) Residential Supports eliminated.

Residential Support Services
Service Definition and Required Components:
Residential Support Services provides assistance with acquisition, retention, or improvement in skills related to activities of daily living, such as personal grooming and cleanliness, bed making and household chores, eating and the preparation of food, and the social and adaptive skills necessary to enable the individual to reside in a non-institutional setting. Habilitation, training and instruction, blended with elements of support, supervision and engaging participation, are combined to reflect the natural flow of training, practice of skills,
and other activities as they occur during the course of the person’s day. This service is distinctive in that it includes habilitation and training activities, as well as care and assistance with activities of daily living when the individual is dependent on others to ensure health and safety. ...


Page 97: Residential Services replaces Residential Supports and is now non-habilitative:

Q. Residential Services
Service Definition and Required Components
Residential Services provides personal care and supervision for individuals residing in out of home placements. These homes include licensed residential Group Homes and Alternative Family Living Homes (AFLs) and residential settings not requiring licensure such as one person Alternative Family Living Homes and One Person Group Homes. A one person group home is a home that is operated by a provider agency. In a One Person group home if the participant wishes to change to a different Residential Service provider, the individual is required to move to another location/residential setting.


Residential Services includes personal care and assistance with activities of daily living as appropriate for the support need of the individual. The service also provides assistance, support, supervision, and monitoring that supports individuals to participate in home or community activities. This service is not a habilitative service; however, the service should be conducted in a manner that promotes and encourages independence. ...

Page 100: Again, an AFL is habilitative:

Additional Guidance:
For the purposes of the CAP-I/DD waiver, an Alternative Family Living Home or Adult Foster Home for one person is provided as an out of home placement for a person who chooses this setting or whose family cannot provide care for that person. The individual receives 24-hour care from and lives in a private home with a family in a home environment where the services are for the care and/or habilitation of the individual. The home does not require a license because it serves only one adult with a developmental disability. The LME and targeted case manager jointly monitor the health and safety of the participant. ...

HHS Committee Meet 6/5 & Bills

Corrected Notice

NORTH CAROLINA HOUSE OF REPRESENTATIVES
COMMITTEE MEETING NOTICE
AND
BILL SPONSOR NOTIFICATION
2011-2012 SESSION

You are hereby notified that the Committee on Health and Human Services will meet as follows:
DAY & DATE: Tuesday, June 5, 2012
TIME: 10 :00 am
LOCATION: 544 LOB
COMMENTS: Added bills H1003 and H1055; removed S525.
The following bills will be considered:
BILL NO. HB 1003
SHORT TITLE Child Nutrition Program Solvency and Support.
SPONSOR Representative Howard 
BILL NO. HB 1055
SHORT TITLE Eliminate LME Provider Endorsement.-AB
SPONSOR Representative BurrRepresentative Dollar
BILL NO. HB 1056
SHORT TITLE Partnership for Children Participant Records.
SPONSOR Representative BurrRepresentative Dollar 
BILL NO. HB 1075
SHORT TITLE LME/MCO Governance.
SPONSOR Representative DollarRepresentative Burr 
BILL NO. HB 1081
SHORT TITLE Provisional Licensure Changes Medicaid.-AB
SPONSOR Representative BurrRepresentative Dollar
Respectfully,
Representative Current, Chair
Representative Dollar, Chair
Representative Hollo, Chair

I hereby certify this notice was filed by the committee assistant at the following offices at 11 AM o’clock on June 04, 2011.

Principal Clerk
Reading Clerk – House Chamber

Wendy Miller (Committee Assistant)

Reminder: 6/4 Town Hall Meeting Tonight!

Alliance Town Hall Meeting Reminder

When: Mon, June 4, 5:30pm – 7:00pm
Where: Durham Main Library; 300 N. Roxboro Street; Durham, NC (map)

Description
ALL STAKEHOLDERS AND THE GENERAL PUBLIC ARE INVITED TO A “TOWN HALL MEETING” TO DISCUSS THE PUBLIC BEHAVIORAL HEALTHCARE SYSTEM IN DURHAM AND WAKE COUNTIES, THE MERGER OF THE DURHAM CENTER AND WAKE LME, THE UPCOMING TRANSITION TO MANAGED CARE OPERATIONS UNDER MEDICAID WAIVERS, AND OTHER RELATED TOPICS.

Spanish and ASL translation provided
Sponsored by Durham CFAC and Alliance Behavioral Healthcare

31 May 2012

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May 2012 events and updates.


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    30 May 2012

    NCGA HHS 5/31 Meeting & Bills

    NORTH CAROLINA HOUSE OF REPRESENTATIVES
    COMMITTEE MEETING NOTICE
    AND
    BILL SPONSOR NOTIFICATION
    2011-2012 SESSION

    You are hereby notified that the Committee on Health and Human Services will meet as follows:
    DAY & DATE: Thursday, May 31, 2012
    TIME: 10 :00 am
    LOCATION: 1228 LB
    COMMENTS: Bills Added
    The following bills will be considered:
    BILL NO. : HB 1075
    SHORT TITLE : LME/MCO Governance
    SPONSOR : Representative Dollar, Representative Burr 
    BILL NO. : HB 981
    SHORT TITLE : Dix Property Sale to Require GA Approval.
    SPONSOR : Representative HurleyRepresentative Dollar
    Representative Burr
     
    BILL NO. : SB 433SHORT TITLE : Local Human Services Administration.
    SPONSOR : Senator Hartsell

    Respectfully,

    Representative Current, Chair
    Representative Dollar, Chair
    Representative Hollo, Chair

    I hereby certify this notice was filed by the committee assistant at the following offices at 9 AM o’clock on May 30, 2011.

    Principal Clerk
    Reading Clerk – House Chamber
    Wendy Miller (Committee Assistant)

    NC DHHS DMA CAP I/DD Public Comments Dox

    Where are the voices you ask?...

    Whenever the Department of Health and Human Services / Division of Medical Assistance proposes new policies and / or policy changes, they are required to post them online for so many days for public review and comment. Policy proposals on all Medicaid related topics can be found here. Spring of 2011, the two Clinical Coverage Policy proposals for CAP IDD 8M were posed for public review comment twice.

    ORIGINAL PROPOSED CLINICAL POLICIES for CAP-IDD:
    NOTE: The 15-day posted proposal drastically differs from the 45-day posted proposal, with a total of 14 pages deleted from the second proposal posted.
    Comments were made from across North Carolina by many parents and caregivers sharing heartfelt details of their lives as well as professionals, providers, and advocates in the DD field who know well the devastating impact such changes and service cuts would have not only on the recipients and families they serve and care for, but on their small businesses, their livelihood and the lives of staff they employ as well.

    On behalf of Isabel and all her special friends, Thank You! - each and every one of you for all that you do and sacrifie to give our children a Voice!

    It is our sincerest hope that our elected officials - our Governor and members of the North Carolina Senate and House of Representatives - aspiring candidates, policy-makers, Health and Human Services administrators, LME's, MCO's, and other stakeholders and powers that be take the time now to hear that voice as our lives are in your hands... not merely the quality of our lives but rather our ability to live.

    PUBLIC COMMENTS on CAP-IDD CHANGES:

    Mary K. Short was kind enough to forward the compilation of comment documents along after finally receiving them from DMA. Thank you Mary.

    *Please note: Though public documents, I have done my best to remove personal contact information to include email and postal addresses for individuals. 
    In a message dated 5/29/2012 2:27:25 P.M. Eastern Daylight Time, brad.deen@dhhs.nc.gov writes:Dear Ms. Short,
    Again, I apologize for the email mixups. Attached are the public comments you requested. If we can assist further, please do not hesitate to call me.
    Brad DeenNC DHHS, Office of Public Affairs919-855-4840
    Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized State official. Unauthorized disclosure of juvenile, health, legally privileged, or otherwise confidential information, including confidential information relating to an ongoing State procurement effort, is prohibited by law. If you have received this e-mail in error, please notify the sender immediately and delete all records of this e-mail.
    -----Original Message-----From: "Skinner, Eric"
    To: "Bush, Melanie E"
    Subject: FW: Public comments Date: Wed, 9 May 2012 17:06:27 +0000
    Here is the first email.
    Eric Skinner Administration Services Officer Director's Office NC DHHS Division of Medical Assistance
    1985 Umstead Drive 2501 Mail Service Center Raleigh, NC 27699-2501 919-855-4108
    919-733-6608 (fax)

    From: Terrell, Sandra D
    Sent: Wednesday, May 09, 2012 12:28 PM To: Skinner, Eric Subject: FW: Public comments
    Eric:
    This was sent on April 10th but to Brad Deen who sent it to DMA clinical policy. There is another email with attachment to follow.

    From: Johnson, Susan
    Sent: Wednesday, May 09, 2012 12:12 PM To: Terrell, Sandra D Cc: Crosbie, Kelly Subject: FW: Public comments
    Sandy,

    There was so much info, I divided and sent in two emails. My next email will be the remainder. Please let me know if you have any questions. Thanks
    Susan E. Johnson Developmental Disabilities Manager Behavioral Health Section, Clinical Policy Division of Medical Assistance 919.855.4299 susan.e.johnson@dhhs.nc.gov
    From: Johnson, Susan
    Sent: Tuesday, April 10, 2012 12:12 PM To: Deen, Brad Cc: Crosbie, Kelly Subject: Public comments
    Brad,

    Attached you will find the first part of the public comments. I am sending the second in the next email.
    Susan E. Johnson Developmental Disabilities Manager Behavioral Health Section, Clinical Policy Division of Medical Assistance 919.855.4299 susan.e.johnson@dhhs.nc.gov
    Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized State official. Unauthorized disclosure of juvenile, health, legally privileged, or otherwise confidential information, including confidential information relating to an ongoing State procurement effort, is prohibited by law. If you have received this e-mail in error, please notify the sender immediately and delete all records of this e-mail.
    -----Original Message----- From: "Skinner, Eric"
    To: "Bush, Melanie E"
    Subject: FW: Public comments 2 Date: Wed, 9 May 2012 16:52:23 +0000
    Do you want me to forward this to Brad? You weren’t’ copied on this.
    Eric Skinner Administration Services Officer Director's Office NC DHHS Division of Medical Assistance
    1985 Umstead Drive 2501 Mail Service Center Raleigh, NC 27699-2501 919-855-4108
    919-733-6608 (fax)

    From: Terrell, Sandra D
    Sent: Wednesday, May 09, 2012 12:29 PM To: Skinner, Eric Subject: FW: Public comments

    The second set. Again, sent on April 10th to Brad Deen
    From: Johnson, Susan
    Sent: Wednesday, May 09, 2012 12:12 PM To: Terrell, Sandra D Cc: Crosbie, Kelly Subject: FW: Public comments

    Sandy, Here is the 2nd email sent.
    Susan E. Johnson Developmental Disabilities Manager Behavioral Health Section, Clinical Policy Division of Medical Assistance 919.855.4299 susan.e.johnson@dhhs.nc.gov
    From: Johnson, Susan
    Sent: Tuesday, April 10, 2012 12:14 PM To: Deen, Brad Cc: Crosbie, Kelly Subject: Public comments 2
    Brad,
    Here is the second set of comments. This set is from the 15 day posting. Please let me know if you have any questions. Thanks
    Susan E. Johnson Developmental Disabilities Manager Behavioral Health Section, Clinical Policy Division of Medical Assistance 919.855.4299 susan.e.johnson@dhhs.nc.gov