March 18, 2019
The long session of the General Assembly is in the thick of its work at this point. Appropriations subcommittees are meeting multiple times a week, the Governor’s proposal has started the budget process, and other committees are moving bills along. Here’s a quick look at some of the bills that the General Assembly is currently considering:
H. 70, Delay NC Health Connex for Certain Providers: NC Health Connex is the Health Information Exchange (HIE) for North Carolina electronic health records data. The state is meeting federal requirements by implementing the HIE. This bill would delay mandatory participation until June 1, 2021, a one-year extension of previously legislated deadlines, for certain providers, including BH/IDD providers. The bill would also allow Innovations and other I/DD providers to voluntarily participate in the HIE connectivity and electronic health record data transmission. The bill would also allow NC DHHS to grant an exemption from the HIE participation for qualifying providers, including small providers, on a case-by-case basis when it would impose an undue hardship. The bill lists potential qualifying criteria for an exemption. Finally, the bill explicitly states that data submitted to the HIE is confidential and not subject to public records statutes. The bill is currently moving through the House. It is sure to meet some resistance in the Senate as Senator Ralph Hise, Chair of the Senate Finance Committee and a member of the Senate Health Care Committee, has already stated his concern about extending the connectivity deadline.
H. 75, School Mental Health Screening Study: NC DHHS and the Department of Public Instruction are required to conduct a study and report findings by February 15, 2020. The study will look at whether the State should require a mental health screen to identify school-aged children at risk of harming themselves or others. Further, NC DHHS and DPI will make recommendations on the type of screening, who may conduct the screening, the behaviors and diagnoses that flag the need for a screening, confidentiality issues, and a procedure for parents to opt in to the screening. There has been some concern already that such a screening may disproportionately affect children of certain races and ethnicities. Presumably these types of issues will be worked through in the study. The bill has passed the House so will remain alive throughout the long and short sessions of the General Assembly.
Additionally, a series of bills have been introduced that will move North Carolina further along in the social service and child welfare restructuring. Many are sponsored by Rep. Sarah Stevens, co-chair of the Child Well-Being Transformation Council as well as the Social Services Regionalization and Collaboration Work Group.
H. 291, Continue the Social Services Regional Supervision and Collaboration Working Group: The Working Group, comprised of representatives from State and local social services, legislators, judges and other stakeholders, completed two reports. They concluded that the regionalization of local social services should not be mandatory, among other things. This bill would continue their deliberations to further consider the relationship between State and local social services as well as to consider the interagency collaboration needed between counties. Two reports are indicated in the bill. Rep. Stevens has said that it may be amended to add an additional 6-months to their work and to allow for former State Senator Tamara Barringer to continue her role as co-chair.
H. 320/S. 212, Suspend Child Welfare/Aging Component of NC FAST: NC DHHS has been working to build out the functions of NC FAST, the IT system for the State social services eligibility system. This bill would suspend any work to expand the NC FAST capacity to include case management for social services and aging. Both the House and Senate bills have been referred to the respective Health Care Committees.
Several pieces of legislation are expected to prepare for the implementation of the Medicaid 1115 waiver Standard and BH/IDD Tailored Plans. Department leaders indicated to the Joint Appropriations Committee members that they will seek legislation in areas such as: Appeals and Technical Changes; Clarifying Language on Populations and Services; Assessments and Supplemental Payments; GS 122(c) Changes; Tribal Option in addition to the premium tax levy listed below.
S. 144, Modify Intent/Gross Premiums Tax/PHPs: Prepaid Health Plans that will be administering Standard Plans through the four statewide contracts and the Provider-Led Entity contract will be treated as other health plans and insurers. PHPs will apply the premium tax to their capitation, and this would begin on June 30, 2019. The bill has already passed the Senate and has been received by the House for consideration.
Both the House and Senate have set deadlines for bills to be drafted and to be filed. Public bills and resolutions that do not have appropriations or finance implications must be drafted in the Senate by March 13,in the House by March 27; and filed by April 2 in the Senate and April 16 in the House. The House distinguishes that public bills with appropriations or finance must be drafted by April 3 and filed by April 23. The general rule is that every bill that does not include an appropriation must pass at least one of the houses of the General Assembly by May 9th to remain active for consideration. This is called the Crossover Deadlines. Once a bill does meet crossover, it can remain active throughout the long and short sessions of the biennium.