News from the NC General Assembly
News from the NC General Assembly
Legislative Update
News from the NCGA
May 2, 2016
by Tony Adams, Adams and Associates Government Relations


Medicaid Reform Public Hearings

Before the 2016 short session of the NC General Assembly convened on April 25, the NC Department of Health and Human Services held 12 public hearings on the Medicaid Reform plan approved by the Legislature in 2015. The public hearings began on March 30 and ended on April 18. Each session began with a brief Medicaid reform plan presentation, followed by the opportunity for the public to give input on the draft Medicaid Reform waiver application (Section 1115 demonstration waiver). Hundreds of people attended the hearings to listen to the presentation and share thoughts on the draft NC Medicaid Reform plan. Many speakers urged the Governor to seek an expansion of the Medicaid program in North Carolina, which he has not, to date, agreed to do.

Hundreds attended hearings to share thoughts on the draft NC Medicaid Reform plan.

Although the public hearings (and the official public comment period) have ended, the Department welcomes additional thoughts about the Medicaid reform plan. Comments can be shared using an online form, by US Mail, or email. The DHHS Web site is: www.ncdhhs.gov.
Senior Living Guide

Step Therapy Reform

The House Select Committee on Prescription Drug Step Therapy met for its fourth and final meeting on April 19 to vote on a recommendation to give to the House of Representatives during the 2016 Short Session of the General Assembly. The recommendation passed the committee and will be introduced as a bill during the Short Session, which convened on April 25. The recommendation reduces barriers to healthcare across North Carolina and continues a dialogue on how to address the prescription drug abuse epidemic in North Carolina.
The recommendation expresses findings about the process of step therapy: a process by which patients have to fail-first and progress through a number of drugs that insurance companies require in order to gain access to drugs prescribed by doctors. This portion of the recommendation ensures proper administration of step therapy through requiring clinical practice guidelines that are developed and endorsed by an independent, multi-disciplinary panel that both patients and practitioners have access to a clear, convenient and transparent process to request an override determination which will be granted under certain circumstances.
Committee Chairman Rep David Lewis had this to say about the recommendation:
“Ensuring access to healthcare that is responsive to individual medical situations and preserves the doctor-patient relationship is vital to quality healthcare outcomes. Doctors should be making decisions about medications with their patients to prevent lengthy appeals processes with insurance companies and frequent denials by a party that has little knowledge of the specific medical situation. I think this is a great step towards improving access to care for all North Carolinians, especially those vulnerable with life threatening medical conditions.”
All About Seniors

Governor’s Proposed Budget

The full details of Governor Pat McCrory’s proposed budget adjustments for the 2016-17 Fiscal Year have been released. The governor’s proposal invests in crucial areas including education, public safety, health and human services, as well as other needs in matters of importance to the people of the state. Last week, legislators received a detailed briefing from State Budget Director Andrew Heath on the proposal, which is available here.
Since highlights were released last week, the governor’s budget proposal has received praise for building up the state’s rainy day fund, controlling government spending, investing in needed areas like public safety and mental health, and raising teacher pay to $50,000 for the first time in state history.
Of particular interest to health providers, the governor’s budget proposal includes the following:
  • Invests $30 million to implement the recommendations of the Governor’s Task Force on Mental Health and Substance Use, including transitional housing, case management, mental health first aid training, child crisis centers, tools to combat the heroin and opioid epidemic, as well as evidence-based specialty courts, including drug and veteran treatment courts.
  • Provides $3 million to expand Medicaid services for older adults, including those with Alzheimer’s disease, by adding 320 new slots to the Community Alternatives Program for Disabled Adults.
  • Increases funding by $1 million for family caregiver support services, including respite care for caregivers.
  • Invests $2.5 million to expand Medicaid services for people with developmental disabilities and children with Autism. This investment supports an additional 250 Medicaid Innovations Waiver slots, providing the needed services to help individuals with developmental disabilities to live successful lives in the community.
  • Provides recurring funding to support the education of future healthcare professionals at the Brody School of Medicine at East Carolina University.

Bill to Appropriate Funds
for Dementia Caregiver Program

The proposed bill, filed in the House of Representatives on April 27, is an act appropriating funds to NC DHHS to support the Project Caregiver Alternatives to Running on Empty Program and the No Wrong Door to Accessing Benefits 4 Initiative. It directs the Department to explore and report on possible expansion of North Carolina’s Medicaid Home and Community Based services waiver programs, as recommended by the Joint Legislative Oversight Committee on Health and Human Services. There is appropriated from the General Fund to the Department of Health and Human Services, Division of Aging and Adult Services, the sum of $500,000 for the 2016–2017 fiscal year.
Development and implementation of this initiative shall include at least all of the following:
  1. Enhancement of the NC 2-1-1 database by migrating Alzheimer’s disease and dementia-related information from community resources into the existing NC 2-1-1 database.
  2. Management of Alzheimer’s disease and dementia-related stakeholder partnerships.
  3. Evaluation and planning for statewide implementation of the No Wrong Door to Accessing Benefits initiative.
By October 1, 2016, the Department of Health and Human Services shall explore and report to the Joint Legislative Oversight Committee on Health and Human Services and the Joint Legislative Oversight Committee on Medicaid and NC Health Choice on options for expanding the number of slots and the types of services available under North Carolina’s Medicaid Home and Community Based Services Waiver programs, including the Community Alternatives Program for Disabled Adults (CAP/DA) and the Community Alternatives Program for Choice (CAP/Choice) in order to increase access to adult daycare, personal care, and caregiver respite services.

State Licensing Boards

North Carolina legislators have backed off a proposal to eliminate state licensing requirements for a dozen occupations and consolidate other occupational boards.
Members of the Joint Legislative Administrative Procedure Oversight Committee meeting in early April shelved draft legislation for the upcoming General Assembly session, which started April 25. The decision for inaction came after people associated with the boards or the professions regulated spoke at the committee and urged lawmakers not to move forward. Bill supporters said licensing boards lower barriers for job seekers in professions and reduce customer costs. Committee co-chairman Rep Jonathan Jordan of Ashe County said more information is needed from the boards to ensure public health and safety are protected.
For more information about the North Carolina General Assembly, or to identify your legislators, please visit www.ncleg.net. For more information on these and other legislative issues, please contact NCALA.

ADAMS AND ASSOCIATES GOVERNMENT RELATIONS

1706 Rangecrest Road, Raleigh, NC 27612
(919) 841-0964    (919) 801-1837 Cell
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