Busy Legislative Session is Underway

As expected, the 2019 long session of the General Assembly is busy with committees meeting regularly.  The budget, initiated by the House this year, is expected to be published at any moment.  At that point, activities will likely ramp up to chaotic.  The bill filing deadlines for both the House and the Senate have already passed.  The crossover deadline is May 9^th.  If a bill that does not have an appropriation attached to it does not pass one of the houses of the General Assembly by crossover/May 9^th, it will no longer be active in this session.  Any bill that does have an appropriation attached to it does not have to meet crossover.  Even if a bill does not meet crossover, there is a chance that the bill will be included as a special provision in the budget or could be attached to an active bill.  These kinds of opportunities make for a lot of wheeling and dealing in the halls of the legislature. 

As of April 29^th over 1,000 bills have been filed in the House and nearly 700 bills have been filed in the Senate.   A number of those bills are related to MH/IDD/SUD services.  All of these bills can be found on the General Assembly website by choosing “find a bill” and putting the bill number into the search engine on the top right corner of the homepage.  Here’s a sample of some of the more notable bills:

System Change

• H822 calls for NC DHHS to submit to the legislature a Comprehensive Behavioral Health Plan for the State.  The Plan would include a 10-year vision for Medicaid, Health Choice and state-funded MH/IDD/SUD services.  
• H440 would appropriate funds to conduct a feasibility study for having regional behavioral health crisis centers.  The study would be done through Partners LME/MCO and findings would be reported by February 2020. 
• H360/S624 provides for a grant-in-aid for Guilford County to construct a facility-based mental health crisis center for adults. 
• H983 appropriates funds for two Peer Wellness Center pilots—one in a rural community and one in an urban community. 
• H990 aims to stabilize community-based group homes that receive State funds and are licensed under Chapter 122C.  The bill calls for a NC DHHS report by November 2019 to the legislature on a more appropriate and sustainable service model for residents of licensed, community-based group homes, including a new rate model.  It also includes a transfer of $26 million for each fiscal year of the biennium, non-recurring, from the General Fund to assist with the transition to a new model. 
• S549 creates a two-year child welfare and behavioral health pilot program that focuses on comprehensive services for foster care children.  The purpose of the pilot project is to establish a trauma-informed integrated health foster care model. 

Medicaid Change

• H656/S548 makes various updates to the language related to Medicaid and Health Choice clinical coverage, including Medicaid beneficiary appeals, adverse determinations for services, requests for disenrollment, BH/IDD Tailored Plan closed networks, adds Medicaid beneficiaries in foster care to those who can be covered by Prepaid Health Plans (PHPs) and sets the Medical Loss Ratio for PHPs at 88% (therefore they cannot spend more than 12% on administration).
• S387 sets minimum work and community engagement requirements for Medicaid beneficiaries.   
• H5/S3 have been introduced to expand Medicaid and close the insurance coverage gap. 
• H555 makes changes to the Medicaid and Health Choice telemedicine and telepsychiatry policies to increase access to services.  On the House Health schedule for this week. 
• S570/H883 would bring dental services for Medicaid and Health Choice beneficiaries under managed care. 

Social Services and Juvenile Justice

• H935 will allow for the repurposing and redeployment of positions within the NC Division of Social Services to create 7 regional child welfare and social service centers along with other changes needed per the Performance Improvement Plan that NC DHHS has developed. 
• H291 will extend the Social Services Regional Collaboration Work Group and the Child Well-Being Transformation Council. 
• H613 makes changes to Chapter 122C to allow for an unaccompanied homeless minor to consent to certain health services. 
• H580/S636 raise the foster care rates.
• H121, H609, S413 and S614 further specify provisions related to Raise the Age of juvenile jurisdiction. 

Education

• S601 are recommendations on School-Based Mental Health that are based on the deliberations of the School Mental Health Initiative.  This is a joint effort by the Departments of Public Instruction and Health and Human Services. 
• H75 calls for a study on the implementation of school mental health screenings for children who are considered to be at-risk of harming themselves and others. 
• H76 is the School Safety Omnibus legislation that covers a spectrum of school safety issues and links LME/MCOs with students referred by the Superintendent.

Workforce and Administrative Practices

There are numerous bills that make changes to professional licensures, postpone the HIE participation of some MH/SUD providers and exempt some IDD providers, and call for a study to identify where there is administrative duplication causing a burden for MH/IDD/SUD providers.