Showing posts with label disability advocacy. Show all posts

27 January 2013

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.

01 December 2012

Tillis Requests Special Session To Address PCS/Group Home Crisis

From The Arc of North Carolina

Tillis Requests Special Session To Address PCS/Group Home Crisis

Special Session first step to solve crisis before Holiday break

Speaker of the NC House Thom Tillis has formally requested that Governor Perdue convene a Special Session of the General Assembly in order to address the looming Personal Care Services (PCS) crisis that threatens the housing of thousands of people with disabilities living in group homes.

The Arc of North Carolina is thrilled by this development and appreciates the Speaker's leadership on this issue and his continued dedication to North Carolinians with intellectual and developmental disabilities.

The Arc will continue to keep you updated on the PCS/Group Home Crisis as it develops. Please check www.ArcNC.org for information as it happens.

The Arc's advocacy staff is evaluating it's next steps in terms of advocacy. Look for an action alert next week.

The letter from the Speaker's office is below. See a copy of the original here.

---

Governor Perdue,

As you know, the General Assembly appropriated $39.7 million in this year's budget to provide for temporary, short-term assistance to residents who would no longer be eligible to receive Medicaid State Plan Personal Care Services under the new eligibility criteria, effective January 1, 2013. The budget provision was drafted as a short-term measure to ensure the funds went to those affected residents who would be potentially discharged from their facility, but would not immediately have a safe community placement. This budget provision was intended to prevent the Department of Health & Human Services from using funds for administrative expenses, appeals, rent deposits, or other items, as requested by the Department during budget negotiations. The Blue Ribbon Commission was summarily tasked with developing long-term solutions to ensure Medicaid beneficiaries receive the services they need.

The General Assembly has been working diligently over the last several weeks and months to determine solutions that would prevent the potential unintended closure of mental health and IDD group homes at the conclusion of this calendar year. It is now incumbent upon all of us to do what is necessary to solve this problem. In order to ensure that our state's most vulnerable citizens are protected and allowed to remain in their homes, it is my opinion that legislative action by the General Assembly is needed. Therefore, I respectfully request that you convene a Special Session of the General Assembly under the authority granted to you by Article Ill, Section 5(7) of the North Carolina Constitution.

The North Carolina House of Representatives stands ready to take immediate action to resolve this impending problem. If you should decide to convene a Special Session, you have my word that no additional matters will be taken up by the House of Representatives. We will act quickly and decisively to protect the residents of mental health and IDD group homes, and the session will end when that action is concluded.

I look forward to your prompt reply. Thank you for your time and attention concerning this very important matter.

Sincerely,
Thom Tillis

cc: Senator Phil Berger

10 October 2012

Medicaid Block Grant & Impact on IDD Populations

From The Arc of the United States

Medicaid Block Grant Information

How will Medicaid Block Grants Impact People with Intellectual and Developmental Disabilities and their Families?

[ original post on thearc.org ]

Introduction

The House Budget Resolution for FY 2013 calls for drastic cuts to Medicaid ($810 billion over 10 years) that would fundamentally reshape the program—making it less reliable for the people who depend on it and shifting costs to consumers and to the states.

For millions of people living in poverty, Medicaid is a safety net. For many of the 7 million people with intellectual and developmental disabilities (I/DD), Medicaid is a life line. People with I/DD typically require more complex and costly services than Medicaid recipients without disabilities. Frequently, they need care from several different types of health care providers and they often need the services throughout their lifetimes.

What is a Medicaid “block grant?”

A Medicaid block grant would be a fixed amount of money from the federal government to the states to spend on health care for people who are poor, elderly, or have disabilities with only general rules and very little oversight about the way it is spent.

Based on previous federal block grants and the general statements that House Budget Committee Chairman Paul Ryan has made about the FY 2013 House Budget Resolution, we expect that a Medicaid block grant would:

cap the amount the federal government spends on Medicaid.
NOT increase this amount to keep up with health care inflation.
radically cut the federal share of Medicaid.

Why do some Members of Congress want to block grant Medicaid?

All health care spending is growing. Experts claim that it will continue to grow and become an ever larger share of our federal budget. Most Members of Congress are looking for ways to get our fiscal house in order. Some Members of Congress are focusing on the growth of federal spending in the Medicaid program. They believe that block granting Medicaid will save federal dollars. Under a block grant, federal funding for Medicaid would not grow when more people need health services. The challenge of providing health care without any additional federal money to people who are poor, elderly or have disabilities would fall to the states.

What are the most critical Medicaid services for people with I/DD and how does Medicaid pay for them?

The most critical Medicaid services for people with I/DD are:

Acute care - including hospital care, physician services, and laboratory and x-ray services. These acute care services are mandatory which means they must be provided to everyone who is eligible. States have the option to offer (and most do) prescription drugs, dental, physical therapy, speech therapy, prosthetic devices and other services.
Long term services and supports - including help getting dressed, taking medication, preparing meals, managing money, getting in and out of bed.

Medicaid is a shared program between states and the federal government and each pays for part of it. The federal share of Medicaid ranges from 50% to 75% of costs. As the need for Medicaid grows in the states, the federal government spends more.

Is Medicaid an entitlement program?

Yes. This means that if a person meets the eligibility requirements (generally poverty, age and/or disability), he or she is entitled to the services available under the state Medicaid program.

What are people with disabilities currently entitled to in the Medicaid program?

Today, each state’s Medicaid program is required by the federal government to provide a minimum level of coverage for the elderly, people with disabilities, and low-income adults and children in order to receive federal matching payments. Minimum services include seeing a doctor, getting x-rays, going to the hospital, receiving care in a nursing home and vaccines for children. Nursing home care is also an entitlement and Medicaid pays for almost half of the long-term care expenditures in this country. It is the primary payer of long-term services and supports for people with I/DD.

What might states do if Medicaid is block granted?

Block grants could force bad choices and cause substantial conflict as groups with diverse needs compete for scarce dollars. Since the services to people with disabilities and the elderly are significantly more costly than health care coverage for children, states could decide to serve fewer costly adults and people with disabilities and focus scarce health care dollars on less costly children. However there is no certain way to know what states will do. Below are possible choices states might make:

States may reduce coverage of home and community-based services (HCBS) and supports. Most people who need long term services prefer to receive them at home. Over 650,000 people with I/DD receive long-term services paid for by Medicaid. States could decide to stop providing these services or limit the number of people who could get them. There already are over 300,000 people with I/DD on waiting lists for Medicaid home and community-based services. There are 730,000 people with I/DD living with aging caregivers who are approaching the time when they no longer will be able to care for their adult children with I/DD at home. If states stopped providing long-term services for people with I/DD, the waiting lists would grow and the situation for older caregivers would become more dire.
States may decide to move people into institutions. Under a block grant, rules for providing quality care could be more flexible and conditions in institutions could return to the way they were in the past. With fewer requirements, it may be cheaper for states to care for people with I/DD in large facilities.
States may reduce eligibility by making it more difficult to meet financial or other criteria. To be eligible for Medicaid, people have to be poor. States could restrict health care services to only the very, very poor.
States may increase the cost burden on the individuals or family members. States may decide that families should take care of their family members who are elderly, ill or have disabilities. States might decide that sons and daughters should care for their parents when they become frail or ill without any public dollars. In order to get health care, people might have to pay more out of their own pockets. Since people on Medicaid are poor to start with, requiring them to pay for their medical care or long term services and supports could be an insurmountable barrier.
States may eliminate or reduce the availability of critical services such as personal care, prescription drugs, rehabilitative services, or home and community based waiver programs. All of these services are “optional” under Medicaid meaning that states may choose to provide them under their Medicaid plans or not. If funds become scarcer, states may decide to stop providing these optional services.
States may slash the amounts they pay to doctors and other providers. It is already very difficult for people using Medicaid to find doctors and other health care providers. Finding a dentist or a specialist, such as a neurologist, is impossible in some communities. If states cut the amount they pay doctors and other providers, those professionals may quit serving people under Medicaid making the problem even worse.

If people with disabilities lose their entitlement to Medicaid, couldn’t they just purchase private insurance instead?

No. Most people with I/DD cannot get medical insurance through an employer because they do not work full time. In fact only 21% of people with all disabilities are working (March 2011). Others cannot find health insurers who will sell them policies because of their pre-existing conditions. Many people with I/DD cannot afford health insurance. Some people with I/DD find that if insurers will sell them policies it does not cover the services they need or the coverage is exorbitantly expensive.

Why are we concerned that services to people with disabilities might be targeted in the states if Medicaid is turned into a block grant?

People with disabilities and the elderly account for most of the Medicaid spending. While children and parents make up about 75 percent of Medicaid enrollees, they account for less than a third of the spending. In contrast, the elderly and individuals with disabilities make up about 25 percent of enrollees but about two-thirds of spending. Medicaid spending per capita in 2009 was $3,442 for families (parents and children) and more than five times higher for the elderly and people with disabilities at $17,763. The elderly and people with disabilities use health care services more often and use more health services and the elderly and people with disabilities are more likely to use long-term services and supports. We are very concerned that states may slash the supports that help people with I/DD live independent, productive lives.

Are block grants cost effective?

A Medicaid block grant doesn’t control the cost of health care which continues to rise as people get older and use more health care services and as the general cost of all health care increases. They do shift more of the cost to that state and likely the individual. Costs may actually rise significantly because people who lose their health care or can’t afford it will stop seeing their doctors or taking their medication. When that happens it makes existing health conditions worse leading to more doctor or hospital visits and more costs down the road and the individual faces more illness and hardship. If home and community based services are reduced it will likely lead to greater levels of costly and unnecessary institutionalization or homelessness. If people are not provided needed services they may not be able to work, learn or function in the community. This creates lost productivity from the individual and family members if they are called upon to provide care when there are no other options.

What can advocates do?

Advocates must make clear to their Members of Congress that block granting Medicaid is not the answer to our nation’s deficit. Advocates must tell their Members what exactly is at stake. The health of people with I/DD may very well be at stake if it becomes more difficult or costly to access needed health services. What will happen if you or your family member loses services under Medicaid or if you have to pay for long term services and supports? Advocates must let their Members know what the biggest concerns are for individuals and families with I/DD if state Medicaid programs are turned into block grants. With less money, would states make it more difficult to become eligible for Medicaid?

Would they cut benefits?
Would they cut current levels of spending?
Would they decide not to cover currently eligible populations?
Would the states stop serving certain groups of people?
Would they stop providing entire categories of services?
Would people with I/DD be able to obtain health care?
Would people with I/DD have long term services in community settings or would they be forced into institutions?

We must make our voices heard. We all understand that sacrifices will need to be made to address our nation’s money problems. Advocates need to help Congress understand that solving these problems is going to take a common sense, balanced approach. We cannot solve our problems only by focusing on the poor, the elderly, and people with disabilities.

[1] Center on Budget and Policy Priorities Rhode Island’s Global Waiver not a Model for How States Would fare under a Medicaid Block Grant, March 2011. Rhode Island’s block grant is held up as a model by some supporters of block grants. However, the state’s fixed amount of federal funds was greater than their normal federal share of Medicaid dollars. Rhode Island’s program does not reflect what likely would happen under block grant proposals currently being discussed. There also is disagreement about the state’s claims of savings under its block grant.

30 September 2012

What's New in September

September 2012 news, events, and updates.

added to Google Calendar of Events

NCGA Housing Subcommittee Meeting Notice for Blue Ribbon Commission 9/12.

added to Google Calendar of Events

[ What's New Main ]

23 September 2012

Come to the Candidate Meet & Greet 9/25

Join us for a Candidate Meet & Greet co-sponsored by Disability Rights NC and The Coalition. The event will be held on Tuesday, September 25, 2012 from 5:30 – 7:30 pm at the Contemporary Art Museum, 409 W. Martin Street in Raleigh. The Meet & Greet will be held in conjunction with National Voter Registration Day and the Horowitz Your Land/My Land: Election ’12 art exhibition at the CAM.
Talk to candidates from across North Carolina and get engaged!

This is a free event but please let us know if you plan to attend. You can RSVP online at http://www.signupgenius.com/go/4090E4DAFAE22A20-candidate, call 919-856-2195, or email us at info@disabilityrightsnc.org.

13 September 2012

10,000 Blog Views! and Counting...

This week, the blog reached 10,000 page views! North Carolinians (and others across the country) are watching - and inquiring minds wanna know...

At the time of the June 16th posting, the blog had reached 5,683 since February of 2012, when first launched. Since that time, the hits have more than doubled from viewers in at least 63 counties across the State of North Carolina and beyond.

Once more, I'd like to point out that regarding total hits, the number (10,143 as of this posting) reflected to the right of the page (previously located at the bottom) is the correct total of page views since the initial launch of this parent / public information blog back in February of 2012. StatCounter was installed in May, so the data you see compiled via the blog's StatCounter statistics only reflects activity from May onward, mostly because I just haven't bothered to change it.

Viewers include loads of parents / family members as well as provider agencies and professionals, LME / MCOs, universities and research groups, risk management groups, PR firms, law firms, advocacy organizations, and both state and federal government offices (*although due to the ambiguity of government IP data, it's impossible for a novice like me to know which specific offices nor even agencies are viewing)...

Some of the more interesting regular (and some once or twice) NC viewers include: Duke University, UNC Chapel Hill, UNC Charlotte, the Department of Veteran Affairs, the North Carolina Research and Education Network, Disability Rights NC, The Arc of NC (and various county chapters), NC Justice Center, NC Council of Community Programs, Crossroads Behavioral Healthcare (now Partners Behavioral Health Management), Daymark Recovery Services, Piedmont Behavioral Health, Sandhills Center, Saguaro Management and Accounting Services, Inc. (providing billing, human resources, program development and quality and risk management to human services companies), the Mental Health Association of Forsyth County, Raleigh's Campaign Connections PR firm, and numerous NC Government offices and agencies around the state.

And beyond North Carolina's borders: Kansas Health Institute, Virginia Commonweath University (VCU), Minnesota State Colleges and Universities, University of Georgia, Emory University, DC's American University, FHC Health Systems, Hospice of the Western Reserve in Ohio; Charleston, SC's New Hope Treatment Centers; HMS (a public government and managed-care contracting company); Deloitte, Marsh USA, and Alvarez & Marsal (each being US consulting / risk management firms with varying specialties); Nelson Mullins Riley & Scarborough LLP, Drinker Biddle, and Hunton and Williams (each are national / multi-state law firms); and yes, even the US Centers for Medicare and Medicaid as well as a few hits from US Government offices in Washington, DC.

Yep, as election season launches into full swing (or sling as is oft the case), the world IS watching to see what North Carolina will do with it's special populations -- even if the usually less-than-enthusiastic main-stream media assignments and focus generally fall short in the real-life, human interest for "those people" and their families - because let's face it, nobody really wants to talk about what they don't understand, especially if it makes them sad...

The 38th Vice-President of the United States, Hubert H. Humphrey, once said oh-so wisely, "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."

It's one of my favorite quotes and oh-so-fitting... and if you happen to be a quote-y kind of person like me and enjoy wise words, here's another for ya...

"Open your mouth for the mute, For the rights of all the unfortunate. Open your mouth, judge righteously, and defend the rights of the afflicted and needy." --Proverbs 31:8-9

So rest assured North Carolina, Inquiring Minds DO Wanna Know.

And to all the blog followers, the advocates, the exhausted parents, supportive family members; loyal and dedicated direct care staff, Case Managers, and various professionals (our personal community villages) who go above and beyond every day to make our lives possible... and to all the people of conscious who listen, who care, who try and try again - and who never, ever give up because you know what is right and just and because it's just not in your soul's design to believe that one life is worth less than another... I'd like to take this opportunity to say Thank You!

Oh, I mentioned 63 counties; here they are... Clicking on the County links below will take you to the corresponding State representatives page on the North Carolina General Assembly's website.

Alamance County
Beaufort County
Bertie County
Brunswick County
Buncombe County
Burke County
Cabarrus County
Caldwell County
Catawba County
Cherokee County
Cleveland County
Cumberland County
Dare County
Davidson County
Duplin County
Durham County
Edgecombe County
Forsyth County
Franklin County
Gaston County
Granville County
Guilford County
Halifax County
Harnett County
Haywood County
Henderson County
Hertford County
Hoke County
Iredell County
Jackson County
Johnston County
Jones County
Lee County
Lenoir County
Lincoln County
Macon County
McDowell County
Mecklenburg County
Monroe County *voter representation falls under Union County
Moore County
New Hanover County
Onslow County
Orange County
Pasquotank County
Pender County
Pitt County
Polk County
Randolph County
Robeson County
Rockingham County
Rutherford County
Sampson County
Stanly County
Stokes County
Transylvania County
Union County
Wake County
Watauga County
Wayne County
Wilkes County
Wilson County
Union County
Yancey County

To find out who your voting representatives are, visit the NC General Assembly search page.

For more on who's involved and how to advocate, see Speak Up!

07 September 2012

NC Trainings re Innovations Waiver & Advocacy

Transition to Managed Care Advocacy Trainings

[ from Disability Rights NC ]

Free Training Opportunity

NC Innovations Waiver: Advocating for Appropriate Services Under the Managed Care System

As our state transitions to a managed care system, Disability Rights NC is here to help you understand what this means for you and your loved ones. We are holding a series of free trainings in collaboration with Family Support Network of NC local programs. We have lots of locations and dates coming up. Tell us which one you will be attending by clicking here to register or contact your local Family Support Network coordinator at http://www.fsnnc.org/findlocal.

In this training, staff from Disability Rights NC will discuss:

The transition to managed care
“How-to” advocacy skills to help families protect a person’s rights during and after the transition
How care coordination differs from case management
Strategies on navigating Medicaid appeals and how the process changes under managed care
General self-advocacy tips

BRING YOUR QUESTIONS AND CONCERNS!

Upcoming Trainings

Rockingham -- September 5, 2012 at 12:00 pm (noon)
Thomas H Leath Memorial Library, 412 E. Franklin St, Rockingham, NC 28379

Sanford - September 13, 2012 at 12:00 pm (noon)
Lee County Arts & Community Center, 507 Steele St, Sanford, NC 27330

Fayetteville - September 14, 2012 at 10:00 am
CDSA, 1211-A Ireland Dr, Fayetteville, NC 28304

Charlotte - September 20, 2012 at 12:00 pm (noon)
Location TBA

Hickory - September 25, 2012 at 12:00 pm (noon)
Patyrick Beaver Memorial Library, 375 Third St NE, Hickory, NC 28601

**Pittsboro - September 27, 2012 (Time TBA)
Location TBA

Lumberton - September 28, 2012 at 12:00 pm (noon)
Partnership for Children, 210 E. 2nd St, Lumberton, NC 28358

Rocky Mount - September 28, 2012 at 12:00 pm (noon)
Braswell Memorial Library, 727 N. Grace St, Rocky Mount, NC 27804

*Goldsboro - October 3, 2012 at 6:00 pm
Wayne County Public Library, 1001 E. Ash St, Goldsboro, NC 27530

Raleigh - October 4, 2012 at 7:00 pm
Good Shepherd Lutheran Church, 7000 Creedmoor Rd, Raleigh, NC 27615

Wilmington - October 11, 2012 at 12:00 pm (noon)
New Hanover County Public Library - Northeast Branch, 1241 Military Cutoff Rd, Wilmington, NC 28405

*Jacksonville - October 11, 2012 at 6:00 pm
Onslow County Public Library, 58 Doris Ave E, Jacksonville, NC 28540

Winston-Salem - October 25, 2012 at 6:00 pm
Little Creek Recreation Center, 610 Foxcroft Dr, Winston-Salem, NC 27103

Burlington - November 8, 2012 at 7:00 pm
LIFESPAN Circle School, 919 Stokes St, Burlington, NC 27215

*Goldsboro and Jacksonville events are not coordinated by local Family Support Network programs.
**Disability Rights NC is participating as a panelist in a program coordinated by FSN on Managed Care.

02 September 2012

Parent Guest Contributor: Anna Cunningham

There's a lot going in North Carolina regarding the statewide 1915(b)(c) Medicaid Waiver and CAP I/DD / mental health reform / overhaul... more than any one person (be it parent or professional, or I dare say, legislative member) can keep up with.

As a short-staffed working mother of a DD teenager and new "typically developing" kindergartener, I often find it difficult to keep up with posting even the basic important stuff between "regular life" and "special life"...

I mean, as working parents of school-age children, we all know what it's like running the rat-race juggling our routine responsibilities, meet deadlines, pay bills, grocery shop, squeeze in the occasional doctor or hair appointment, and lug our kids around to various activities, play dates and so on... I do all that too.

But to put things in perspective for those working parents fortunate enough not to have to deal with the struggles and challenges of caring for and protecting a child (or adult) with Intellectual Disabilities, here's a breakdown of my extra "special" obligations so far for this calendar year:

1 three-day hospitalization,
22 (usually day-long) medical appointments with doctors and specialists (to include: dental, endocrinology, behavioral, neurology, gastroenterology, ophthalmology, orthopedics, medical rehabilitation, and physical therapy),
2 (2+ hour) IEP's (last calendar year there were 5 or 6),
3 CAP-related meetings (not including countless phone calls), and
5 other special DD involved events, meetings, and happenings.

Those are just the appointments and meetings specially relating to the specialized care, well-being and education of my daughter and does not include sick days, Miracle League baseball games, legislative assemblies, meetings with Senators and Representatives, DWAC meetings, other advocacy meetings and rallys, nor does it include any of what most of us would consider "routine" responsibilities as a grown-up and a parent, such as extra-curricular activities and appointments for my "typical" child, nor for myself (as if I had time for me)...

Which is why I've frequently been asked, "When do you sleep?!" Well, I don't, much.

That's just how we special parents roll.

But because the future of our children and their peers during this transition period is so vitally important and there's a great deal of important information to get out, explain, break down, dispel, and share with others, I've invited fellow Special Mother and Advocate, Anna Cunningham, to join in the blogging fun.

It's not uncommon when I'm out banging cans and preaching my cause to be asked if I know Anna or for someone wanting to connect us... I mentioned that to Anna when we spoke regarding sharing the voice of the World Wide Web; she laughed and said the same thing happens to her about me. ;-)

More about Anna...

03 August 2012

Volunteers Needed: NCDVRS Community Rehabilitation Program (CRP) Steering Committee

From the NC Department of Health and Human Services: NCDVRS Community Rehabilitation Program (CRP) Steering Committee

Volunteer Application

Volunteer Policy

Title of committee: NCDVRS Community Rehabilitation Program (CRP) Steering Committee

General overview of committee’s purpose: Employment Service Providers, known as Community Rehabilitation Programs (CRPs), are integral partners in the network of services designed to provide people with disabilities with equal opportunities in achieving their highest level of economic and social independence. With representatives from DVR, DMH/DD/SAS and CRP providers, the NCDVRS CRP Steering Committee focuses on budgetary and program issues and makes recommendations to the NCDVRS Division Director. The committee’s goal is to help ensure the delivery of quality services with informed choice by our consumers. More information on the workgroup can be found at the bottom of this webpage.

Specific Criteria being sought for consumer/family member representation: MH or MH/SA co-occurring or DD Consumers

Number of individuals need for the group: 2

Additional skills or knowledge required of individuals participating in the group: We are seeking consumers who have experienced VR services and/or have tried to access VR services and may have ideas to share on improving the quality of services.

When and where does the committee meet and how frequently? This committee meets quarterly at the NCDVRS offices on the Dix Campus, Raleigh, NC.

Date and time of the first meeting: Next meeting is tentatively scheduled for October 3rd, 2012

Does the opportunity for teleconference or webinar exist? (Briefly explain) Yes, a call-in number is available but attendance in person is preferred.

Is there any remuneration for participants? If yes, please describe in detail. No

Deadline by which recommendations need to be received: Friday, August 10, 2012

What is the selection process? Participants will be selected based on the criteria above (background with VR service/access) and a random sample will be chosen.

01 August 2012

DRNC PAIMI Advisory Council members needed

Disability Rights NC's PAIMI Advisory Council is in need of members from Region 2 (counties listed below). Applications are available on the Council's web page along with further information about the Council.

At least 60% percent of the Council is to be comprised of individuals who have received or are receiving mental health services or family members of such individuals with the Council striving to maintain a balance between consumers and family members.

In addition to geographic representation, the Council is mandated to include at least: one family member who is the primary caregiver for a minor child who is receiving or has received mental health services, one attorney, one mental health professional, one provider of mental health services and one member of the public who has demonstrated a substantial commitment to improving mental health services.

Right now, however, the Council's greatest need is for members from Region 2, regardless of whether they fit a specific slot, although fitting one or more of the mandated slots is certainly a plus. Those interested and living in other regions are certainly encouraged to apply as well with their applications considered as the need arises.

My thanks in advance,

David

Region 2 counties:

Anson
Cabarrus
Davidson
Davie
Forsyth
Guilford
Iredell
Montgomery
Randolph
Richmond
Rockingham
Rowan
Stanly
Stokes
Surry
Union
Yadkin

31 July 2012

Free Event: Role of Advocates in Health Care Reform 8/24

From: Titus, Trina
Tue, Jul 31, 2012 at 11:15 AM
Re: URGENT - AUGUST 24 CONFERENCE - PLEASE READ

Hi Coalition, PLLF, and Other Colleagues

On behalf of the Steering Committee for the Patient Advocacy Leaders Summit I want to ask your help in spreading the word far and wide about the PALS conference to be held on Friday, August 24 at the Friday Center in Chapel Hill.

The theme of the day is "The Impact of Health Care Reform on Patients: what is the Role of Advocates?" Attendance is aimed at people in advocacy, policy roles - members of your staff, CFAC members, anyone who is interested in public policy around health care reform and how to make an impact for people.

There is no charge for this event - the Steering Committee has received a grant from GSK which is being administered by the NC Psychological Foundation.

*See attached flyer and registration form.*

Due to the funding, licensed providers and state employees are not eligible to attend.

A list of the Steering Committee is posted below.

WE NEED YOUR HELP. Please send this information out to your networks to encourage people to attend. It is an excellent opportunity to hear from Pam Silberman from the NC Institute of Medicine about what will happen now that the Supreme Court has upheld the Affordable Care Act. The person who will be speaking on using social networking and media messaging is an expert who will give us practical advise on these important tools.

Lunch and the afternoon will be devoted to brainstorming about practical ideas and solution in North Carolina.

While this isn't just about behavioral healthcare we want a huge showing from our community.

Please send this far and wide, consider having someone from your staff attend. Thanks and let me know if you have any questions.

Really appreciate your help.

Sally

Sally R. Cameron, Executive Director

NC Psychological Association & Foundation

1004 Dresser Court #106

Raleigh, NC 27609

919-872-1005 phone

919-872-0805 fax

ncpasally@mindspring.com

www.ncpsychology.org

CONFIDENTIALITY: This e-mail (including any attachments) may contain confidential, proprietary and privileged information, and unauthorized disclosure or use is prohibited. If you receive this e-mail in error, please notify the sender and delete this e-mail from your system.

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.

2 attachments

PALS Program FINAL.doc (464K)

Registration Form Final.doc (821K)

13 July 2012

DRNC : Request for Public Input

Survey from Disability rights NC regarding target / focus areas in the new fiscal year.

Disability Rights North Carolina is our State's protection and advocacy system for its citizens with disabilities. We provide individual and systems advocacy, including legal representation, to people with disabilities when their legal rights are violated. We uphold the provisions of the Americans with Disabilities Act and other federal and state laws.

Each year, we establish Targets that guide how we spend our resources for the coming year. These Targets drive the work that we do. They influence the work we do and the cases we take.

In fiscal year 2011 (October 1, 2010 - September 30, 2011), we received more than 2,300 calls for assistance but had the resources to provide direct advocacy for only 852 callers.

On June 15, 2012, the Board of Directors of Disability Rights NC tentatively approved its Targets for 2013 which are now out for public comment through the middle of August. The Board will carefully consider all public input received before finalizing the 2013 Targets at its September Board meeting. We do this to make sure that we are spending our resources the way the disability community feels is important.

Our proposed 2013 Targets continue to focus on the impact of the state budget cuts to services for people with disabilities. They also reflect the requirements of our federal funders.

Please let us know what you think about the proposed 2013 Targets by responding to this survey. It should take about 15 minutes but that time will help us make better decisions about how to spend our limited resources next year.

Please share the link to this survey with your friends, family and anyone who cares about people with disabilities.

If you need assistance in completing this survey, contact Haydee Martinez at 919-856-2195.

Si necesitas ayuda o traducción en español para completar esta encuesta por favor llame a Haydee Martinez al 1-877-235-4210 or 919-856-2195 or haydee.martinez@disabilityrightsnc.org.

30 June 2012

What's New in June?

June 2012 events and updates.

Parent Legislative Correspondence: SB 191 v 4: LME Governance, 6/28.
Family Perspective: DMA 8M Clinical Coverage Policy proposal, Public Comment 361.
Guardianship Issue and NCGA Senate Bill 191, 6/27.
Message from The Arc of NC, 6/27.
Provider Perspective: DMA 8M Clinical Coverage Policy proposal, Public Comment 292.
Family Perspective: DMA 8M Clinical Coverage Policy proposal, Public Comment 220.
Family Perspective: DMA 8M Clinical Coverage Policy proposal, Public Comment 293.
In case you're wondering who I am...
Mecklenburg County area Waiver Extensions.
Parent Correspondence and news articles questioning ECBH money management, 6/25.
Parent Legislative Correspondence re: "Oversight of Quality of Care in Medicaid Home and Community Based Services Waiver Programs.", US HHS, CMS, & PBH, 6/25.
Family Perspective: DMA 8M Clinical Coverage Policy Proposal, Public Comment 257.
Family Perspective: DMA 8M Clinical Coverage Policy proposal, Public Comment 323.
Opened the master Google Docs Repository re all things HB916 / Medicaid Waiver related for public viewing and download, 6/24

Google Docs link posted on Documents page.

Public Perspective: DMA 8M Clinical Coverage Policy proposal, Public Comment 227.
Parent Perspective: DMA 8M Clinical Coverage Policy proposal, Public Comment 257.
Parent Perspective: DMA 8M Clinical Coverage Policy proposal, Public Comment 266.
Parent Perspective: DMA 8M Clinical Coverage Policy proposal, Public Comment 289.
Parent Perspective: My Comments to the DHHS Waiver Advisory Council on 6/20.
DRNC Press Release: Move to Intervene in ACH matter v. NC DHHS/DMA from 6/19.
DHHS Waiver Advisory Committee Meeting Agenda for 6/20.
NC DHHS Press Release re: Medicaid Leadership Reorganization, 6/19.
Smokey Mountain Center's 6/13 NC Innovations Services Presentation and info.
Associated Press article: "NC Medicaid director is out of a job," from 6/19.
Winston Salem Journal article, "Changes to bill would give more power to groups overseeing mental health services" from 6/18.
N&O article, "Costs soar for updating NC's Medicaid computer system" or Thing$ that Make U$ go Hmmm, from 6/17.
Parent Legislative Correspondence: re PBH LME staff salaries & expenses, 6/18.
Parent Correspondence: PBH Inquiry regarding executive salaries, 6/18.
Blog Stats & Audience Following - Medicaid Waiver Interest for inquiring minds...

No2NCHB916.blogspot.com StatCounter now Public
added a Blog Stats quick link on the left.

N&O article: "Judge halts effort to assign adult care homes special status" from 6/15.
N&O article: "Medicaid budget to come up $75M short" from 6/15.
Parent Legislative Correspondence: A Blast from the Past - 2007 Issues same as today in parent email archives, 6/14
Carolina Journal Online article, "Medicaid Reforms May Leave Developmentally Disabled Out in the Cold; Unintended consequence of 2011 law to improve treatment of mentally ill" by Barry Smith from 6/11 as well as personal comments.
Parent Perspective: N&O article "NC lawmakers direct another mental health overhaul" and Personal Comments, 6/13.
Sign The Arc of NC's Online Petition!

http://www.change.org/petitions/nc-leadership-change-house-bill-916

Parent Perspective: Legislative Correspondence: An Open Letter & Outline of Critical NC Medicaid Waiver Issues for DD Citizens, 6/11.
Parent Perspective: Legislative Correspondence to Representative Tim Moffitt from 5/31.
Parent Perspective: Legislative Correspondence to Senator Tommy Tucker from 5/30.
Parent Perspective: Legislative Correspondence to Representative Bill Current from 5/30.
Attended the NC Behavioral Health and I/DD System Leadership Congress at UNC Chapel Hill with the Jordan Institute for Families, 6/8.
Email from CMS re: Comprehensive and Supports Waivers, 6/6.
NCGA 6/12 HHS Committee Meeting Notification & New Bills.

added to Google Events Calendar

CMS Denies CAP I/DD Waiver set to begin 7/1; Current Waiver Extension to be Requested, 6/5.
Parent Perspective & Legislative Correspondence from Parent Mary Short re: 8M Clinical Coverage Policy proposals & Public Comment to DMA, 6/4.
Public & Parent Perspectives: More on DMA's 2011 Clinical Coverage Policy proposals, the Public Comments received, & a quick rundown of the first proposal by parent, Mary K. Short.
Reminder: Alliance LME Town Hall Meeting in Durham tonight! 6/4
HHS Committee Meeting 6/5 and Bill Sponsor Notification.

added to Google Events Calendar

[ What's New Main ]

20 June 2012

DRNC Press Release: Move to Intervene in ACH matter

Disability Rights North Carolina

FOR IMMEDIATE RELEASE

Tuesday, June 19, 2012

Disability Rights NC Moves to Intervene in

Tiffany Healthcare, Inc., et al., Petitioners v.

North Carolina Department of Health and

Human Services, Division of Medical Assistance

Raleigh - Disability Rights NC filed a motion to intervene in the case Tiffany Healthcare, Inc., et al., Petitioners v. North Carolina Department of Health and Human Services, Division of Medical Assistance. This case was filed last Thursday on behalf of the owners of eighteen Adult Care Homes (ACHs) who were notified that as Institutions for Mental Disease (IMD), their residents were no longer eligible to receive services under Medicaid.

“The outcome of this case could have a profound effect on the welfare of adults with mental illness – people we are mandated to protect,” said Vicki Smith, executive director of Disability Rights NC. “In the event that the Court rejects Tiffany Healthcare, Inc’s claim, the subsequent loss of Medicaid funding would require a change in the residential placements of more than one thousand individuals. Many of these residents live with mental illness. All of the residents are disabled to some degree.”

A little over a year ago, the Centers for Medicare and Medicaid Services (CMS) informed NC DHHS/DMA that it must develop a method of determining whether ACHs whose residents receive Medicaid benefits qualify as IMDs. NC was required by CMS to develop a protocol to assess whether certain ACHs meet the definition of an IMD and to assure that Medicaid dollars were not being used inappropriately to pay services to residents of those homes.

If the Court rules in favor of the State, the consequence would be the immediate termination of Medicaid payments to the facility. One likely consequence is that, once found to be an IMD, an ACH may face immediate closure owing to the loss of a significant revenue stream for the facility. It is also possible that the ACH might fail to provide the required 30-days’ notice of discharge to each resident. More important, the need to find alternative placements for all of the discharged ACH residents could overwhelm the ability of the local Department of Social Services and the Local Management Entities to meet the discharge needs of the displaced residents as guaranteed by law.

Smith stated, “In the event that the affected residents lose their Medicaid eligibility, an orderly process for locating alternative housing – which is required by law – must be assured. Both Chambers of the General Assembly have recognized the need to budget some transitional support for ACHs. It is our hope that those funds will be specifically targeted to pay for residents’ medications and other medical expenses while alternative housing and services are located. ”

The Court issued a TRO on Friday, June 15 preventing the State from immediately terminating Medicaid benefits. Further proceedings are scheduled at the Office of Administrative Hearings for June 28th.

Background on North Carolinians with Mental Illness Housed in Adult Care Homes

The state’s practice of employing adult care homes as the default residential placement for people with mental illness has been a longstanding subject of interest, investigation and study by Disability Rights NC. In July 2010, Disability Rights NC filed a complaint with the U.S. Department of Justice claiming that the practice of warehousing adults with mental illness in adult care homes violated the Americans with Disabilities Act and the U.S. Supreme Court’s decision in Olmstead v. L.C., 527 U.S. 581 (1999). One year later, the Department of Justice issued a letter containing its findings, and concluded that “adult care homes are institutional settings that segregate residents from the community” and that those with mental illness “are relegated indefinitely and unnecessarily to adult care homes because of systemic State actions and policies … .”

###

Disability Rights North Carolina is a 501(c)(3) nonprofit organization with offices in Raleigh and Asheville. Its team of attorneys, advocates, paralegals and support staff provide advocacy and legal services for people with disabilities across North Carolina. As the state’s federally mandated protection and advocacy system, Disability Rights North Carolina is charged with finding and fighting the abuse and neglect of people with disabilities.