Showing posts with label NCGA. Show all posts
Showing posts with label NCGA. Show all posts

04 June 2013

The Lost Art of LISTENING.

Before I launch into what will probably be my last post (though don't hold me to it), I want to introduce you to Raleigh Attorney Knicole C. Emanuel with Williams Mullen and her most excellently well written and legally sound Medicaid law blog. In my humble opinion, anyone who can so eloquently and factually draw a strong comparison and contrast between Shakespeare's "MidSummer's Night Dream" and the Medicaid providers' prepayment nightmare is nothing short of a poetic knight in shining armor (yes, chicks can be knights too - why not?)

Now, on with the show...

So, people keep asking where I've gone? Commenting that they've not heard much from me lately... Well, the truth is, that while I have been known to talk to myself on occation, there are some conversations that really need a active partner for successful dialogue. 

Frankly, I'm all talked out at the moment.

American author and journalist, Ernest Hemmingway was quoted as saying, "I like to listen. I have learned a great deal from listening carefully. Most people never listen."

Stephen R. Covey, author of The 7 Habits of Highly Effective People: Lessons in Personal Change said, "Most people do not listen with the intent to understand; they listen with the intent to reply.” 

Therein lies the problem. Nobody's listening.

Everyone has something to say in this Medicaid quagmire - the MCO's and LME's have plenty to say, providers have even more to say, DHHS and DMA have their say, facilities and group homes have something to say, advocacy groups keep trying to have their say, consultants and lobbyists get paid the big bucks to keep saying stuff, and members of the North Carolina General Assembly always seem to have the final say... and don't even get me started on the recipients and their family members that most everyone seems to conveniently forget in all this. 

Nobody can keep the stories straight, not even (and often, especially) the media, becasue it appears the right hand doesn't know what the left hand is doing while everybody's busy with their own personal diatribes and ass-saving.

Everybody's talking but nobody's listening.

Nevermind all of the asinine bureaucratic dynamics at play in the dirty politics of the NC Medicaid system - the inappropriate friendships, roles, relationships, mothers / daughters / board members, ethical conflicts of interest, and who's scratching who's back. Yep, we know about all that.

There are way too many egos on the line here (not to mention the obscene amount of money invested), meanwhile we continue to rearrange the deck chairs on the Titanic while ignoring the real issues of human concious. That's right, I said it again.

I find that this is especially true of the current political climate in North Carolina... For the first time in just over 100 years, the Republican party has finally won back the driver's seat and they seem to be hell-bent on making up for lost time with issues far more "important" than the welfare of our state's most vulnerable citizens, with such utter nonsense as nipples, fracking, abortion / right to chooseending size limits for K-3 public school classrooms, teaching about abortion risks in public schools while lifting smoking bans on college campuses, imposing rediculous voting restrictions and flat out denying many the right to vote, slashing unemployment benefits, requiring a 2 year waiting period prior to divorce (ironically dubbed the Healthy Marriage Act), vain attempts to negate the first amendment with a state religion, and arresting peaceful protestorsamong other idiocy. 

Handbasket anyone?

What with all that debauchery going on, who has time to worry about the threat of homelessness to residents of NC group home facilities (yet again)? Or whether developmentally delayed recipients and their tired-ass exhausted families have the resources to make it through yet another day, or even if they do - if they are actually receiving the services they are entitled through all this slimey red tape? 

I mean really? Who cares? We're such a small minority of the State's population when compared with the number of citizens who have nipples, for Christ's sake.

And speaking of Christ... Conservative politicians love to use the Bible as a platform and foundation for their arguments and justifications and while I've been known to agree with certain positions, it should be noted that countless infamous American psychopaths (Charles Manson, Jim Jones, Fred Phelps, etc.) have also used the good book as sources of inspiration and justification... just sayin'.

My Christ is not wrathful nor boastful, not judgmental nor unknind, and is not dis-compassionate nor cruel toward fellow man nor the world we live in. In the documented lifetime of Jesus, he exhibited love and compassion to all, even those who sought to destroy him and especially for those who could not do for themselves. 

I believe Christ to be alive in the very essence of our collective being, our hearts if you will, a state of mind we all should strive toward. --A perpetual state of love and forgiveness... a state of grace and joy I witness every single day in my own special daughter, Isabel, and her special peers. 

Where the hell are our priorities?

It's way past time for the North Carolina "powers that be" to start listening more to the people, their constituents and voting public, who must live with, and at times suffer from, the repercussions of their actions and decisions. 

You do NOT know what is best for me and mine; that, I can guarantee you. And I'm certainly not in the minority there.

Perhaps if everyone suddenly, miraculously began to listen more, really listen, and made an honest attempt at understanding one another, as I believe the late Steve Jordan had hoped, we wouldn't require knights in shining armor to mitigate such a shameful Comedy of Errors... though sadly, nothing seems to grab attention these days (and further waste taxpayer dollars) quite like a good ole American law suit, eh?

Hang in there folks.

28 February 2013

What's New in January & February?


January and February 2013 news, events, and updates.

February
January

21 February 2013

Provider Stonewalling via Paperwork Nitpicking?

Insult to Injury: Expungement?

Re: Talk about insult to injury?!! Fwd: [lme_providers] Expunction of Criminal Records in North Carolina
From: Crystal J. De la Cruz
Thu, Feb 21, 2013 at 1:35 PM


Dear Families, People of Conscience, Senators and House Members, and Federal Representatives,

Pardon my French, but seriously, WHAT THE HELL?

Please see below an listserv I received today in which Eastpointe MCO's CEO, Karen Salaki, offers up to her colleagues and underlings a helpful reference guide to Expunction of Criminal Records in North Carolina presumably for MHDDSA professionals and staff... which, in my humble opinion, is not only completely inappropriate for this field, but begs to question:

  1. Is criminal activity really such a problem for employees in North Carolina's field of Health and Human Services that it warrants dissemination of this information to the entire NC Local Management Providers listserv?
  2. And this problem, is it a global epidemic throughout the entire I/DD field or is it isolated to say, direct care staff who work with clients who can neither defend themselves and, in most cases, communicate their needs or fears?
  3. Is there such a shortage of decent, trustworthy, qualified applicants that we gotta break the levy in order to widen the pool because it's near impossible to find direct care staff willing and able to work for what pitiful portion of funds are left after the hierarchy trickle-down?
  4. Would you knowingly allow a convicted felon (even a non-violent one?) access to your home and more importantly, to babysit your children? How about a someone with just a little ole Class 2 Misdemeanor charge (in NC, charges of Simple Assault and Shoplifting are both Class 2 Misdemeanors, while Speeding is a Class 1) And would you allow this same individual to care for your elderly mother with dementia?
  5. When are we as a society, as a state, as a community - going to STOP subscribing to this unwritten American caste system of human value?

I really hope this is a misunderstanding, however, given the trends of this entire Medicaid process, it feels more par for the course.

We, the parents and family members, are still waiting to be heard and taken seriously regarding our experiences, knowledge, expertise, fears, concerns, and stuff like this that we're simply shocked and appalled about. Gosh, there's really no end to all we could accomplish if we all chose to work together... Just sayin'.

Thank you in advance for you time and attention. As always, please do not hesitate to contact me at any time.


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


----- Forwarded Message
From: Listserve Administration
Reply-To: Listserve Administration
Date: Tue, 19 Feb 2013 16:53:33 -0500
To: NC Local Management Providers
Subject: [lme_providers] Expunction of Criminal Records in North Carolina

To: Provider Network
From: Karen Salacki, Chief of External Operations
Re: Expunction of Criminal Records in North Carolina

Attached is a very helpful guide on how to have eligible offenses removed from criminal records. Please share with applicable staff within your agencies.


This e-mail is for informative purposes ONLY.

Please do not reply to this e-mail.

---

You are currently subscribed to lme_providers as: janet.presson@asmallmiracleinc.com.


To unsubscribe click here: http://lists.unc.edu/u?id=53091867.3571bb40e36a7e70f1361fb08a87d445&n=T&l=lme_providers&o=32779787

(It may be necessary to cut and paste the above URL if the line is broken)

or send a blank email to leave-32779787-53091867.3571bb40e36a7e70f1361fb08a87d445@listserv.unc.edu

Public Records Law Statement:
Please be advised that any e-mail sent to and from this e-mail account is subject to the NC Public Records Law and may be disclosed to third parties.

Confidentiality Statement:
This e-mail transmission and any documents, files or previous e-mail messages attached to it may contain confidential health information, such documents are legally privileged. The authorized recipient of this information is prohibited from disclosing this information to any other party unless required to do so by law or regulation. Recipients are required to destroy such information after its stated need has been fulfilled. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or action taken in reliance on the contents of these documents is strictly prohibited. If you have received this information in error, please notify the sender immediately and delete the e-mail and accompanying file attachment.

------ End of Forwarded Message


EXPUNCTION OF CRIMINAL RECORDS IN NORTH CAROLINA.PDF [460K]

14 February 2013

FW: [ProviderNet] Hundreds of NC Lic. Mental Health Therapist unable to work



From: ProviderNet@yahoogroups.com
Sent: Thursday, February 14, 2013 11:56 AM
Subject: [ProviderNet] Hundreds of NC Lic. Mental Health Therapist unable to work


Hundreds of NC Mental Health Therapist unable to work.

Our newly licensed therapist in our office applied for Medicaid enrollment and were informed that in accordance with North Carolina session law 2011-399:

"The Department shall conduct provider screening of Medicaid and Health Choice providers in accordance with applicable State or federal law or regulation. The Department must screen all initial provider applications for enrollment in Medicaid and Health choice, including application for a new practice location, and all revalidation requests based on Department assessment of risk and assignment of the provider to a categorical risk level of "limited," "moderate," or "high." If a provider could fit within more than one risk level described in this section the highest level of screening is applicable."

Public Consulting Group (PCG) on behalf of the North Carolina Division of Medical Assistance (DMA) will be conducting an onsite screening.

Public Consulting Group (PCG)
877-522-1057
55 Capital Center Drive, Suite 550
Raleigh, NC 27606
 
The session law required the completion of 3- classes however, the classes are NOT available and NO ONE at PCG is answering the phones to provide information.

How can the legislature pass a law mandating the completion of training as a prerequisite for Medicaid Provider enrollment and not ENSURE that the training is available?

We are also being told that DMA will not back date the enrollment date.

So now we have two therapist that cannot provide services to Medicaid consumers and therefore do not earn enough money to support themselves. They are working PT and looking for other work to supplement their income. Many consumers that need therapy don't get it.

Does anyone at the North Carolina General Assembly care about the workers in this state?
Who will fix this?

11 February 2013

legislative correspondance to Senator Neal Hunt


UNSUBSCRIBE & personal note Re: Neal Hunt News
1 message

Crystal J. De la Cruz <delacruz.hopper@gmail.com>Mon, Feb 11, 2013 at 12:46 PM
To: "Sen. Neal Hunt" <Neal.Hunt@ncleg.net>



Dear Senator Hunt,

As your constituent, I met with you last year for a brief half hour regarding critical concerns as a parent for the Intellectually and Developmentally Disabled recipients caught in the middle of North Carolina's Medicaid reform "bru-haha." You were very kind and attentive though by your own admission, you were unfamiliar with the Health and Human Services programs that serve and help support children and adults like my daughter. I left you with quite a bit of paperwork. I never received any feedback, though perhaps I should have been more proactive in following up; I can only imagine however that you are as busy as I am.

I am writing to request that you please unsubscribe me from your mailings. 

I am not interested in political finger-pointing regarding who did why and for how much when current NC House and Senate cannot even be bothered to understand not only the Medicaid budget but the irresponsible dynamics behind the shortfalls and more importantly, the devastating repercussions to our state's most vulnerable citizens. In my humble opinion, we as a state will never be able to move ahead until we ALL begin to recognize our commonalities and work together with the very best of intentions for every one, not just those of like minds. 

Regarding the Medicaid reform, there are still very real issues endangering the livelihood of families such as mine, threatening the supports and services which allow us to work and provide for our families. 

To date, to my knowledge, no one outside of the DHHS "powers that be" and the like (MCOs and LMEs) have been permitted to speak / present to the NCGA nor even to the DWAC, unless you count the 3 minute allotment of time. Advocacy groups such as Disability Rights and The Arc of NC are accused of having an agenda (does not everyone?!!) and family members who sometimes drive hours just to speak up are most often met with condescension.

North Carolina historically is not a proactive state with regards to the welfare of the people. This issue will be no different as there are far too many egos on the line and obscene amounts of money invested in an unprecedented system of care. Meanwhile, it seems no one is interested in hearing from those who have the most to lose - the recipients and their families. Never mind those family members of recipients who are uninsured themselves. 

Our exhausted pleas continue to fall on deaf ears.

Again, I thank you for your time and as always, I invite you to contact me anytime.


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.


"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


On Fri, Feb 8, 2013 at 11:51 AM, Sen. Neal Hunt <Neal.Hunt@ncleg.net> wrote:



Legislative Newsletter


Legislature
309 LOB

February 8, 2013

Business


On January 30th, the General Assembly convened to begin the work of the long session. The pomp and circumstance of opening day is over and it is now time to begin solving our state’s major issues. I’m confident that the Senate will foster solutions to help alleviate our state’s fiscal problems and get us back on the road to prosperity.

The NC Senate leadership will focus on common sense, business-friendly approaches to our state’s fiscal issues. In addition, we will block federal mandates that we know will put North Carolina further into debt. Here is a summary of what we hope to accomplish this session:

1.    The Budget – I have the pleasure of serving as one of the three chairs to the Senate Appropriations Committee. Our state government needs to run a budget like any North Carolina family or business. When the leadership took office in January 2011, we inherited an approximately $3 billion budget shortfall from the previous leadership. This shortfall was created by excessive government spending, termination of federal stimulus dollars, and loss of revenue due to the recession. Last session, we created a balanced budget that cut wasteful spending, lowered taxes, and created more funding for teachers. We will face many challenges due to Medicaid funding and other federal mandates, but rest assured we will pass another balanced, common sense budget.

2.    Tax Reform – We need to modernize our tax system to make our state more competitive with other states and the global economy. North Carolina’s top personal income tax rate is the highest in the South and the 11th highest in the nation. The lowest personal income tax rate is higher than or the same as the highest rate in all but two southern states. Our corporate tax rate of 6.9% is also the highest in the southeast. We must reform our system to promote business productivity and lower our unemployment rate of 9%. Some proposals being discussed that we will explore include:
·         Lower or eliminate the personal income tax
·         Lower or eliminate the corporate tax
·         Broaden and increase our state sales tax to include services (legal fees, haircuts, movie tickets, etc.).
·         Implement a reasonable flat corporate business fee instead of a corporate tax
·         Implement a real estate transfer tax small enough to make sure we don’t stifle transactions.
·         Eliminate taxes on business to business transactions, and
·         It will be revenue neutral.
We also need to address how the poor and elderly will be affected by adding sales tax to
food.  I believe a tax rebate will probably be offered in the event the personal and corporate
income taxes are eliminated. I look forward to debating these proposals as we make sure we
have the best tax reform solution. Our goal is to produce a tax system that is transparent,
simple, and promotes economic growth and prosperity for all.  It is about 50 years overdue as
we transitioned from a manufacturing economy to a service oriented one.
.
3.    Unemployment Insurance Reform – Currently, North Carolina has the most generous unemployment insurance in the southeast. The state is required to repay $2.57 billion to the federal government that was borrowed to pay unemployment benefits after unemployment soared during the recession. This is a heavy burden on our budget, and our businesses that pay for all federal unemployment insurance (FUTA). As long as the money is owed, the federal unemployment taxes that employers pay will increase $21 per employee each year. Our economic situation has left thousands of North Carolinians unemployed and looking for work. We believe we have to provide adequate unemployment insurance to our state’s unemployed, but still remain conscious about our state’s business environment by providing an atmosphere for business and employment expansion.

4.    Election Reform – This session will bring many changes to our election laws, including:
·         Voter ID - Providing photo identification to vote is necessary to combat voter fraud in our state. I have no doubt that a voter ID bill will pass both chambers and that Governor McCrory will sign it into law.
·         Early Voting - I expect we will see an effort to shorten the time period of early voting. This attempt to generate more voters during an election is costly to local government, confusing to voters and has not increased voter turnout.
·         Partisan Judicial Races - I am cosponsoring Senate Bill 39, which will make judicial elections partisan. Voters should not be blind to judicial candidates’ views.
·         Publically Financed Political Campaigns – I believe we will see an effort to eliminate tax payer funding of judicial campaigns.

5.    Medicaid Expansion – In the Supreme Court decision on the Affordable Care Act (Obamacare), the court exempted states from the federal mandate to expand Medicaid eligibility. I do not support expanding Medicaid given the tremendous budgetary burden of an expansion. Just last year, the General Assembly was forced to fill a surprise Medicaid shortfall that totaled more than $500 million. An expansion of the program would add hundreds of millions of dollars in additional state costs to our Medicaid budget through 2019. I am focused on identifying solutions that meet the challenges facing our state and fostering a health care system that offers more accessible and affordable care to North Carolinians.
6.    Obamacare – I have cosponsored Senate Bill 4, a bill that would prevent the establishment of a North Carolina health benefit exchange as provided by the Affordable Care Act (or Obamacare). Senate Bill 4 passed the Senate on February 5th(32-17) and now moves to the House. Obamacare specifies that each state must have in place a health exchange where individuals and small businesses can purchase health care coverage. Implementing a federally mandated, state-run exchange or a state-federal partnership would have serious unintended consequences for NC.  A state-run program will only force our taxpayers to foot a massive bill for administrative, infrastructure, and operational expenses. Obamacare was a federal bill that I and many others believe was a serious mistake.  The states should not be forced to shoulder the burden of funding and implementing it.

We have many great new policy ideas for North Carolina. These policies will lead to private sector job growth, generate a new business-friendly environment and reinvigorate the private sector economy.

As always, I greatly appreciate the opportunity to serve you in the Senate. If you need anything, please don’t hesitate to contact my office; your comments and thoughts are always welcome.

Sincerely,

Neal Hunt


If for any reason you do not wish to receive further newsletters, please reply to this e-mail and type in “Unsubscribe” on the subject line.

Join in the conversation and connect with me on

Twitter @SenatorNealHunt

08 February 2013

Critical Medicaid audit based upon unrealistic demands

http://www.ncpolicywatch.com/2013/02/04/critical-medicaid-audit-based-upon-unrealistic-demands/

Critics of North Carolina’s Medicaid program – the publicly-funded health insurance program for adults and children of low income – made some headlines in recent days by touting a new state audit that supposedly showed a large and previously unreported budget deficit. The critics, who included Governor McCrory and his State Health and Human Services Secretary Aldona Wos, claimed that Medicaid had gone $375 million over budget with state dollars and more than $1 billion over budget when federal dollars are included.

At the Governor’s news conference announcing the audit, DHHS Secretary Wos, lectured the Medicaid section of her agency: “Cost overruns will not be tolerated and will not be acceptable …There’s a budget for a reason.”

Conservatives are also using this audit as a reason for the state not to expand the Medicaid program to cover a half-million uninsured people as made possible by Obamacare (even though the expansion would be financed almost completely by the federal government).

There’s just one problem with McCrory and Wos’ conclusion: It’s bogus.

Like someone demanding blood be squeezed from the proverbial turnip and then professing to be “shocked” when the magic is not performed, the Medicaid “shortfall” is actually the result of absurd and unrealistic demands placed upon the program last year by the General Assembly.

Indeed, as anyone who pays real attention to the Medicaid program could have told the Governor and Secretary Wos last year, the overly-ambitious and ideologically-driven demands imposed by the General Assembly (and passed into law over then-Governor Perdue’s veto) were never realistic. Former Health and Human Services Secretary Lanier Cansler (a one-time Republican lawmaker) made this plain as far back as August of 2011 when he said:

“It’s just really going to be next to impossible to achieve this budget, and I’m not sure where the legislature will go with that. The fact that this budget plays into next year (means next year) is going to be a difficult budget year as well.”

Secretary Cansler reiterated this point in a letter sent directly to Republican General Assembly leaders again on October 27, 2011. According to Cansler:

“…aggressive budget cuts mandated by the General Assembly’s budget are unreasonable and unobtainable.”

Unfortunately, Cansler’s pleas had no effect.

Indeed, despite demanding massive Medicaid cuts, Republican General Assembly members further tied Secretary Cansler’s hands in January 2012 when the prospect of politically harrowing cuts in so-called “optional” services like artificial limbs and ambulance service (as well as major cuts in payments to doctors and hospitals) were on the table. The Legislature simply told Cansler to find other places to close the gap!

But, wait, it gets even more absurd.

Remember the amount in state funding the audit claimed the Medicaid program had exceeded its budget by ($375 million in state funds and $1 billion including federal money)? Here’s an amazing coincidence: Those sums are almost precisely equivalent to program cuts that the General Assembly demanded (but failed to provide the tools to attain) each year!

None of this is to deny the importance of efficiency. In a giant health program like Medicaid, one can and should always look for new ways to make reforms to be more efficient and effective.

But here’s another inconvenient truth for the critics: For the 2007-10 period (the most recent period for which national data are available) North Carolina’s Medicaid program had the lowest rate of spending growth of any Medicaid program in the United States. In fact, North Carolina’s Medicaid program spending growth was about half the national average! Not surprisingly, other states and even private health insurers are actually looking to North Carolina for lessons on how to run their own programs efficiently and effectively.

Got it? Over the last year and a half, in-the-know experts warned state budget-makers (and anyone else who would listen) repeatedly that the Medicaid program would not be able to meet the unrealistic budget set for it by the General Assembly.

For the McCrory Administration and the state auditor to effectively ignore this reality and then express shock and dismay when the program failed to meet such demands is, at best, remarkably disingenuous. At worst, it speaks to intentional misrepresentation of an efficient and effective program that delivers quality health care, garners strong support from the doctors and the hospitals doing the hard work, and makes a huge difference in the lives of over a million of our fellow citizens.

Adam Searing is Director of the Health Access Coalition at the N.C. Justice Center.

29 January 2013

2013-14 DHHS Related Legislative Committee Membership and Full Appropriations


Senate Appropriations / Base Budget (FULL)
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House Appropriations (FULL)
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Vice Chairman
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The names highlighted in yellow are new members to the DHHS related Committees

Senate Appropriations on Health and Human Services
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Co-Chairman
Co-Chairman
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House Appropriations Subcommittee on Health and Human Services
Details
Members
Chairman
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Policy Committees
House Health and Human Services
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Senate Health Care
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