PUBLIC POLICY UPDATE Stakeholder Engagement Group August 10, 2015

DHHS MENTAL HEALTH, DEVELOPMENTAL DISABILITIES AND SUBSTANCE ABUSE  State Task Force to improve collaboration between health care, justice and safety professionals  Medicaid Managed Care and capitated funding  Consolidating LME/MCO operations  Crisis Solutions Initiative for community support (November 2013)  Partnering with Department of Public Safety on ‘Youth Mental Health First Aiders’ and law enforcement training

ABLE ACT  Federal law signed in December 2014  Funds to be used for education, transportation, direct care, housing, technology, and others  NC filed S367 to create 529 plans for ABLE expenses  NC already has 529 plans for education  SEG led to Senate sponsorship at press conference

ABLE ACT – NORTH CAROLINA  S367 has passed both the North Carolina House and Senate  Final step – to be signed by the Governor  There will likely be a signing ceremony this week; will share details  No details yet on when individuals and families will be able to start using ABLE accounts.

INNOVATIONS WAIVER PROPOSAL  DHHS announced proposal and amendments to current Innovations Waiver  Based on statewide listening sessions last fall  Expands resource allocation and individual budgets  Promotes use of self-directed options  Makes changes to general structure to allow greater flexibility and community integration

INNOVATIONS WAIVER COMMENTS  Waiver should be focused on meaningful outcomes  Funding for services continues to vary significantly statewide  New Community Supports and Living to combine personal care and in-home skill building  What is the link between HCBS regulations, Workforce Investment and Opportunity Act (WIOA) regulations, and proposed Medicaid Managed Care regulations?

INNOVATIONS WAIVER COMMENTS  Need greater focus on Person Centered Plan (PCP) and Individual Service Plan (ISP) development  Need greater awareness and understanding of waiver services available to individuals and families  Integrated employment and limited funding for segregated settings  Due process and no hard limits on amount of services (L.S. v Wos)

NC STATE BUDGET  No changes to Medicaid eligibility, benefits or provider rates  $2 million for new Traumatic Brain Injury Waiver  Debate over funding Community Care North Carolina (CCNC)  $23 million to fund US Department of Justice settlement on community support for individuals with mental illness

NC STATE BUDGET- CONFERENCE  LME/MCO funding: Discussion on reducing funds to LME/MCOs and replacing it with existing cash balance  House Case Management Pilot Program: to provide Targeted Case Management for a small number of people with I/DD on the Innovations Waiver waiting list  Medical Expense Tax Deduction: Discussion on removing medical tax deduction  Education Funding: Increase funds to NC START, increase Teacher Assistants and reduce class sizes

MEDICAID REFORM  Fully managed system for ALL Medicaid dollars in 2 years  “Health Benefits Authority” to oversee and operate Medicaid  Keep LME/MCO structure for 3 years, then transition services to other managed care entities

HR 2646 HELPING FAMILIES IN MENTAL HEALTH CRISIS ACT “THE MURPHY BILL”  Bill restricts critical legal advocacy services by limiting the activities of Protection and Advocacy of People with Mental Illness (PAIMI) Act funding grantees.  Limits advocacy efforts to only situations of abuse and neglect, preventing self-advocacy assistance for individuals seeking independence through education, housing, or employment opportunities.  Bill bars advocates from raising concerns with decisions made by doctors, families, or guardians of people with mental illness.  P&A organizations would be required to provide “caregivers,” an undefined term, access to protected health information of an individual with a disability.

 Prohibits P&A organizations from using the use any funds, including money raised from private donations, for use in an expansive definition of lobbying activities.  P&A organizations, like Disability Rights NC, are currently permitted to use these funds, and others, to lobby policymakers consistent with federal and state law  Prevents Disability Rights NC from continuing systemic advocacy on behalf of people with mental illness by limiting advocacy efforts to only matters of abuse and neglect.  PAIMI grantees, such as Disability Rights NC, would be prevented from using funding to investigate death reports, advocate for employment, education, housing, community access, and other healthcare matters. POTENTIAL ACTION: Sign on to a letter expressing concern over HR 2646 HR 2646 HELPING FAMILIES IN MENTAL HEALTH CRISIS ACT “THE MURPHY BILL”

NORTH CAROLINA MENTAL HEALTH AND SUBSTANCE USE TASK FORCE  Announced by McCrory on July 14th  Panel that will bring together the Executive, Legislative and Judicial branches of government  Aims to:  improve connections between health care, justice, public safety  reduce stigma  21 members, including:  State Supreme Court Chief Justice Mark Martin  Health and Human Services Secretary Aldona Wos  Sen. Tamara Barringer  Rep. Susan Martin  Martin will appoint seven members and McCrory will appoint 11  Report due by May 1, 2016

POTENTIAL ACTION: THE COMMISSION FOR MENTAL HEALTH, DEVELOPMENTAL DISABILITIES, AND SUBSTANCE ABUSES SERVICES IS SEEKING MEMBERS  Family members or individual with I/DD  Needs to live in district 6, 10, or 11  6 - portions of Guilford, Alamance, Durham, Granville, and Orange counties, and all of Caswell, Person, Rockingham, Surry, and Stokes counties  10 – all of Cleveland, Gaston, Lincoln and Rutherford counties, and part of Catawba, Iredell, andBuncombe counties.  11 – Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Swain, Transylvania, Yancey  More vacancies are expected shortly  Potentially: MH Family Member, SA Family Member

QUESTIONS AND COMMENTS