Lawmakers debated into the evening, passing the final $21.73 billion after midnight Thursday evening. Photo credit: Rose Hoban


Quantcast

By Rose Hoban and Rachel Herzog

This week, members of the NC General Assembly parsed, debated, argued over and passed a state budget which will finance state government to the tune of $21.73 billion for the coming year. Of that amount, $5.13 billion will go to Health and Human Services.

Every year, we at N.C. Health News spend hours slogging through the text and the numbers to make the year’s budget more discernible to the lay reader. You can look across the table to see what each chamber proposed and what the final compromise between the two chambers ended up being.

This spreadsheet details how parts of the Department of Health and Human Services budget compare between the House version, which was released in May, and the Senate version, finalized in June.

This year, the two chambers have been far apart on their budget proposals, making the comparison longer and more complicated than in years past. That fact has been underscored by an 11 week delay, which was due July 1, but only arrived on Sept. 15.

But once the bill arrived, it passed quickly in the Senate, which saw many of it’s priorities highlighted in the bill, even as House members congratulated their negotiating team on eliminating some of the Senate’s more draconian provisions.

The budget was signed into law on Sept. 18, hours before a resolution that kept state government operating past the July 1 beginning of the fiscal year was due to expire.

Lawmakers debated into the evening, passing the final $21.73 billion after midnight Thursday evening. Photo credit: Rose Hoban
Lawmakers debated into the evening, passing the final $21.73 billion after midnight Thursday evening, Sept 17. Photo credit: Rose Hoban

 

HOUSE

SENATE

FINAL

DHHS ADMINISTRATION

DHHS ADMINISTRATION

DHHS ADMINISTRATION
$7.7M for 2 percent salary increase for agency employees. (also funds will be added for teachers who are on DHHS payroll) Another $2M will fund health benefits, retirement, etc. All state employees will receive $750 one-time bonus. Funds also earmarked for teachers within DHHS. Also eliminates 57 vacancies in DHHS
Reduces funds by $1.48M to eliminate 57 positions. Reduces funds by $1.48M to eliminate 57 positions.
Designates Office of Program Evaluation Reporting and Accountability (OPERA) structure, funding, legal authority, where it falls in the DHHS organizational structure, and what it is supposed to accomplish. Designates Office of Program Evaluation Reporting and Accountability (OPERA) structure, funding, legal authority, where it falls in the DHHS organizational structure, and what it is supposed to accomplish.
Makes all these employees exempt from the State personnel act (EPA).
Adds $500,000 in annual funding to create office of program evaluation and accountability (OPERA) within DHHS. Adds $750,000 over biennium to create office of program evaluation and accountability (OPERA) within DHHS.
Creates funds for design and implementation of contract-based training to create specialist and certification programs for DHHS management personnel, created by the UNC School of Government. Program is intended to be a pilot for all of state government. $150,000 for FY 2015-16 and $200,000 for FY 2016-17 Orders study of a contract-based training to create specialist and certification programs for DHHS management personnel, created by the UNC School of Government. No due date for study report listed.
Reduces funding for contracts in central management by $3.2M, leaving behind $3.1M in contract money.
Orders creation of a consolidated Department of Military and Veterans Affairs, with cabinet level secretary and all veterans’ services consolidated under one department. Orders creation of a consolidated Department of Military and Veterans Affairs, with cabinet level secretary and all veterans’ services consolidated under one department.
Eliminates the Certificate of Need law and all activities related to CON, saving $560,506 in recurring funds in FY 2015-16 and 1,120,013 in FY 2016-17
Eliminates assembly and publication of guide on how people with disabilities can access tourist destinations in NC, ACCESS NC is currently distributed at state welcome centers and by Dept of Commerce and DHHS. Eliminates assembly and publication of guide on how people with disabilities can access tourist destinations in NC, ACCESS NC is currently distributed at state welcome centers and by Dept of Commerce and DHHS. Eliminates one position, saving $41,729
Phases out the process for Certificate of Need approval for hospitals/ health facilities, starting in 2016 and completed in 2019.
Repeals the Certificate of Public Advantage laws by 2016. Was not done in budget but was accomplished in HB20.
Orders DHHS to create a methodology to determine how many hospice beds needed in North Carolina. no mention
Provides a one-time $20M grant for the development of residential (in-patient) hospice facilities. no mention
Provides for continued funding for State Loan Repayment Program for primary care providers who agree to work in rural areas; this includes physicians, surgeons and psychiatrists. The provision also expands the program to providers who use telemedicine in rural and underserved areas. Provides for continued funding for State Loan Repayment Program for primary care providers who agree to work in rural areas; this includes physicians, surgeons and psychiatrists. The provision also expands the program to providers who use telemedicine in rural and underserved areas. Provides for continued funding for State Loan Repayment Program for primary care providers who agree to work in rural areas; this includes physicians, dentists and psychiatrists. The provision also expands the program to providers who use telemedicine in rural and underserved areas.

HEALTH INFORMATION TECHNOLOGY

HEALTH INFORMATION TECHNOLOGY

HEALTH INFORMATION TECHNOLOGY
Creates new state-level Dept of Information Technology. Creates new state-level Dept of Information Technology. Starting in FY 2016-17 all information technology capacity in DHHS will be transferred to the newly created Dept of information Technology.
Provides funds for a “successor” Health Information Exchange Network to which all Medicaid providers need to be connected by July, 2017. Creates legislation known as the “Statewide Health Information Exchange Act” to set up and regulate this “voluntary” HIE, which is also mandatory for Medicaid providers. Provides funds for a “successor” Health Information Exchange Network to which all Medicaid providers need to be connected by January, 2018. Transfers authority for HIT expenditures to state CIO. Creates legislation known as the “Statewide Health Information Exchange Act” to set up and regulate this “voluntary” HIE, which is also mandatory for Medicaid providers.
Allows individuals to opt out of having health information as part of HIE, provides safeguards for those people. Establishes state ownership of all HIE data, and provides mechanisms for access to the data. Information will include demographic and clinical information, but no billing data. HIE collects data from all state-paid-for patients, including Medicaid, Health Choice, LME/MCO and State Health Plan beneficiaries.
Takes $2M for the Health Information Exchange (NC HIE, which shares patient records between hospitals) out of the recurring budget and makes the funds non-recurring, meaning DHHS will have to seek this funding each year as directed by S.L. 2015-7 Funds the current NC HIE for the next six months, until Dec, 2015 until transfer to new Dept of Information Technology takes place: $1,062,000 Funds the current NC HIE for the next six months, until Feb, 2016 until transfer to new Dept of Information Technology takes place: $1,416,000
Moves administration for the NCHIE to DHHS. Moves management of the new HIE from DHHS to a newly-created Department of Information Technology (created in the Senate budget) Moves management of the new HIE from DHHS to a newly-created Department of Information Technology (created in the final budget). Orders status report on HIT efforts to Legislative Oversight Committee by Jan 15, 2016
Creates a state-controlled HIE Authority to oversee and administer the successor HIE network, creates an advisory board to provide consultation. Creates legislative language to create the HIE Authority. Allocates $1,062,000 for start-up costs through Dec, 2015 Creates a state-controlled HIE Advisory Board to provide consultation the successor HIE network, creates an advisory board to provide consultation. Creates legislative language to create the HIE Authority. Allocates $1,062,000 for start-up costs through Dec, 2015
Provides $3.16M in funds to help implement the Health Information Exchange statewide. Allocates $8M in recurring funds and $4M in one time funding for each year of the FY 2016-18 biennium
Mandates the successor HIE become 100 percent receipt-funded by creating “participation fees” Mandates the successor HIE become 100 percent receipt-funded by creating participation fees, (i.e. fees paid by providers for participation in this mandatory program), no deadline set for that goal.
$5.8M of one-time funds to cover a budget deficit in the Division of Information Resource Management
Additional funds of $5.8M and 37 positions for NC FAST, the computer system that will integrate applications for Medicaid and other social service programs. This will bring the total funding for the program to $77.7M Appropriates $9.8M and 3 positions for NC FAST, the computer system that will integrate applications for Medicaid and other social service programs, to keep the system going. Appropriates an additional $6.65M from one fund and $5.3M from another to match federal funds for NC FAST and expedite the implementation of new components of the system. Appropriates $9.8M in receipts and 3 positions for NC FAST, the computer system that will integrate applications for Medicaid and other social service programs, to keep the system going. Appropriates an additional $6.65M from one fund and $5.3M from another to match federal funds for NC FAST and expedite the implementation of new components of the system.
Provides $3.2M in one time and $360,000 in recurring funding to facilitiate changes allowing the Eastern Band of the Cherokee to administer Medicaid and other social services that have been provided until now by the state of North Carolina. EBC will also have access to NC FAST, NC Tracks, and other computer systems to facilitate coordination between state and EBC health authority.
Allocates funding to purchase separate child protective services case management system that can be integrated with NC FAST and instructs DHHS not to move forward with implementing the native system for NC FAST. $8.5M for FY 2015-16 and $17.2M for FY 2016-17 Funds of $5.8M and continues funding for 37 positions for NC FAST, the computer system that will integrate applications for Medicaid and other social service programs. This will bring the total funding for the program to $77.7M
Provides funding for development of Early Childhood Integrated Data System in FY 2016-17, allocates $700K in annual funds, will aggregate data from early childhood education, health, social service and eventually K-12 information.
Allocates $1M in one-time funding to create a data analytics center for DHHS. Allocates $750,000 in one-time funding, and $250,000 in annual funding to create a pilot data analytics program for DHHS.
Governmental Data Analytics Center created in the New HIE Act, embedded in the budget. Allocates $750,000 in one-time funding and $250,000 in annual funding to pay for it.
Allocates $300,000 to continue Child Protective Services Pilot project, develop data dashboard that tracks children across the state, and create comprehensive demographic and caretaker profild of child. Orders DHHS Division of Social Services to work with Government Data Analytics Center to create Child Protective Services Pilot project, develop data dashboard that tracks children across the state, and create comprehensive demographic and caretaker profile of child. Report initial findings to HHS Oversight Committee by March, 2016.
Starting in FY 2016-17 all information technology capacity in DHHS will be transferred to the newly created Dept of information Technology (created in the Senate budget) Starting in FY 2016-17 all information technology capacity in DHHS will be transferred to the newly created Dept of information Technology (created in the budget)
$2.3M in one-time funding plus $400,000 in recurring funding for NC Tracks, the Medicaid claims payment system. The money will be used to bring the system up to compliance with federal requirements for ICD-10, etc. $2.3M in one-time funding plus $400,000 in recurring funding for NC Tracks, the Medicaid claims payment system for the 2015-16 fiscal year. The money will be used to bring the system up to compliance with federal requirements for ICD-10, etc. Allocates $940,000 in one time funding plus $400,000 for FY 2016-17. $2.3M in one-time funding plus $400,000 in recurring funding for NC Tracks, the Medicaid claims payment system for the 2015-16 fiscal year. The money will be used to bring the system up to compliance with federal requirements for ICD-10, etc. Allocates $940,000 in one time funding plus $400,000 for FY 2016-17.
Reduces state funding for NC Tracks by $8.9M in recurring and $19.6 in one time money due to increased federal back reimbursement for the system. Now that the system has been certified by federal officials, the federal match goes up from 50 percent to 75 percent. Reduces state funding for NC Tracks by $8.9M in recurring and $19.6 in one time money due to increased federal back reimbursement for the system. Now that the system has been certified by federal officials, the federal match goes up from 50 percent to 75 percent. Also anticipates $4.77M in annual savings associated with the replacement of the Medicaid claims processing system. A total of $60M has been budgeted for this savings.
Orders quarterly report on NC Tracks to the HHS Oversight Committee with analysis of claims payments, problems with ICD-10 implementation and any hardship advances made to providers arising because of implmentation of ICD-10 (switch is scheduled for Oct 1, 2015).
The budget document outlines goals for DHHS’ Health Information Technology office, including responsibilities, data security, coordination of information among hospitals and providers and the development of a state plan. The budget document outlines goals for DHHS’ Health Information Technology office, including responsibilities, data security, coordination of information among hospitals and providers and the development of a state plan. The budget document outlines goals for DHHS’ Health Information Technology office, including responsibilities, data security, coordination of information among hospitals and providers and the development of a state plan.

MEDICAID

MEDICAID

MEDICAID
Adjusts requirements for eligibility, cost-sharing, vision services, emergency services and co-pays and annual enrollment fees in accordance with federal requirements. Adjusts requirements for eligibility, cost-sharing, vision services, emergency services and co-pays and annual enrollment fees in accordance with federal requirements. Adjusts requirements for eligibility, cost-sharing, vision services, emergency services and co-pays and annual enrollment fees in accordance with federal requirements.
Recalculation (rebase) of the Medicaid program increases the total budget by $287.5M to a total of $3,773B. The rebase takes into account increased enrollment, increased utilization and costs. Recalculates Medicaid eligibility to reflect inflation and the federal poverty guideline updates. Recalculation (rebase) of the Medicaid program provides funds for enrollment and utilization growth of the program: $311M in the first year and by $489M in FY 2016-17. Recalculation (rebase) of the Medicaid program provides funds for enrollment and utilization growth of the program: $299M in the first year and by $496M in FY 2016-17.
Holds all other co-pays, reimbursements and fees at 2015 rates. Holds all other co-pays, reimbursements and fees at 2015 rates.
Allows for establishment of a lifetime maximum benefit for Medicaid beneficiaries, as well as beneficiaries in the NC Health Choice program.
Repeals ability for Medicaid recipients whose income inches above 200 of the federal poverty level to buy into the Medicaid program (This ability was established in 2013 budget)
Creates a new Legislative Oversight Committee on Medicaid and requires DHHS to submit quarterly reports and detailed spending forecasts. Reinstates the annual Medicaid report which was discontinued in 2008. Reinstates Medicaid Annual Report which was discontinued in 2008.
Gives DHHS all control over Medicaid and Health Choice Provides for Medicaid reorganization which includes creation of a Health Benefits Authority, allows both for-profit managed care organizations and locally-created “provider-led entities”, divides states into regions for management of care, orders the creation of a new oversight committee on the health benefits authority, fully capitates contracts by Aug 2017. Takes authority for Medicaid oversight out of DHHS and into the Health Benefits Authority. MEDICAID REFORM POLICY PROVISIONS TAKEN OUT OF BUDGET AND PLACED INTO SEPARATE BILL: SB372
Discontinues the contract for Community Care of North Carolina and the Community Care Networks as of Jan 2016. $97.4M reduction over two years. Ends primary care case management that’s been coordinated through CCNC. If the NC General Assembly does not ratify the Medicaid Reform plan contained in HB 372 by March 1, 2016 the following happens: Contracts for Community Care of North Carolina and Community Care Networks are discontinued; rates for primary care providers will be paid at 100% of Medicare rates; and DHHS will provide $17.3M in funds to local health departments to perform primary care case management that was originally paid for by CCNC.
Increases rates for primary care physicians and OB/GYNs $25.3M in FY 2015-16 and $50.6M in FY 2016-17 see above
Orders health departments to take on some of the Care Coordination for Children previously done by CCNC at cost of $6.48M in FY 15-16 and $12.95M in FY 16-17 see above
Amends the Health Care Cost Reduction and Transparency Act to disclose more hospital pricing for the 100 most frequently reported hospital admissions and services, the 20 most common imaging procedures, etc.
Abolishes medical error reports set up in the HCCRTA statute		 Amends the Health Care Cost Reduction and Transparency Act to disclose more hospital pricing for the 100 most frequently reported hospital admissions and services, the 20 most common imaging procedures, etc.
Abolishes medical error reports set up in the HCCRTA statute
Requires hospitals/ ambulatory facilities to submit the charity care financial report included in the IRS Schedule 990 (only applies to not for profit facilities) to DHHS. DHHS is to take that information and post it prominently on its website, and *cannot* simply post links to the 990 forms. All institutions must also post the data in a conspicuous place.
Creates standards for mental health LME/MCO out-of-network agreements. Creates standards for mental health LME/MCO out-of-network agreements. Creates standards for mental health LME/MCO out-of-network agreements.
Orders movement of $43M per annum out of Medicaid Special Fund and into DHHS appropriations. Orders movement of $43M per annum out of Medicaid Special Fund and into DHHS appropriations. Orders movement of $43M per annum out of Medicaid Special Fund and into DHHS appropriations.
Eliminates $511,800 in annual mobile dental screenings for school children and residents in long-term care because there is no follow-up plan for these recipients. Eliminates $225,900 in FY 15-16 and $511,800 in FY 16-17 in annual mobile dental screenings for school children and residents in long-term care because there is no follow-up plan for these recipients.
Orders DHHS to submit a State Plan Amendment to federal government to assure that ECU and UNC dental schools receive the same reimbursement for care delivered to Medicaid beneficiaries.
Orders a Medicaid survey of pharmacies to determine average cost of dispensing recipients’ drugs. DHHS will then increase the weighted average dispensing fee to cover the cost of filling Medicaid prescriptions, capped at $12/ prescription. Saves the state $4.1M in first year, $9M in the second year. Orders a Medicaid survey of pharmacies to determine average cost of dispensing recipients’ drugs. DHHS will then increase the weighted average dispensing fee to cover the cost of filling Medicaid prescriptions, capped at $12.40/ prescription. Saves the state $3.7M in first year, $8.2M in the second year.
Makes changes in the 340b Medicaid prescription program to incentivize programs to dispense more generics and require pharmacies to invoice the 340B product cost for medications above $1500/ month. Saves $322K in first year and $824K in second year.
Reduces funding for personal services contracts by $850,895 in recurring dollars in both years Reduces funding for personal services contracts by $425,477 in FY 2015-16 and $850,895 in FY 2016-17
Allocates $500,000 in funding to program NC Tracks in order to reimburse pharmacists for providing immunizations. Allocates $500,000 in funding to program NC Tracks in order to reimburse pharmacists for providing immunizations. Allocates $500,000 in funding to program NC Tracks in order to reimburse pharmacists for providing immunizations.
Starting Jan. 1, 2016, pharmacists performing immunizations will be reimbursed at the same rate as for Medicaid and NC Health Choice.
North Carolina is anticipated to receive an additional $33M in federal funds to cover the State Children’s Health Insurance Plan (SCHIP) because of changes to the federal match rate. Even though the program budget will remain about the same, the state will not have to spend that $33M. Senate budget writers anticipate receipt of an additional $39.6M in federal funds to cover the State Children’s Health Insurance Plan (SCHIP) because of changes to the federal match rate in FY 2015-16 and $55.5M in FY 2016-17 Budget writers anticipate receipt of an additional $34.8M in federal funds to cover the State Children’s Health Insurance Plan (SCHIP) because of changes to the federal match rate in FY 2015-16 and $47.3M in FY 2016-17
Increases rates for Medicaid private duty nursing by 10 percent. Increases rates for Medicaid private duty nursing by 10 percent.
Eliminates graduate medical education add-on to inpatient hospital reimbursements, leaves the payment in place for other portions of reimbursement. Saves state $12.75M in FY 2015-16 and $31.13M in FY 2016-17 Eliminates graduate medical education add-on to inpatient hospital reimbursements, leaves the payment in place for other portions of reimbursement. Saves state $12.75M in FY 2015-16 and $31.13M in FY 2016-17
Changes tax formulations for hospitals: Hospitals pay about $189M in assessments to the state in exchange for being able to be reimbursed by Medicaid for providing care. Going forward, this assessment amount is not permitted to be counted as a cost when hospitals perform end-of-year cost settlement accounting with NC Medicaid.
Changes fees to pharmacists for drug reimbursement using “Average Acquisition Cost” formulation. Changes fees to pharmacists for drug reimbursement using “Average Acquisition Cost” formulation.
Raises eligibility for Medicaid for children in low income families to families earning 211 percent of the federal poverty level (up from 200 percent FPL). Raises eligibility for Medicaid for children in low income families to families earning 211 percent of the federal poverty level (up from 200 percent FPL).
Eliminates ability of Medicaid recipient families with incomes that tick above eligibility level to buy into Medicaid program (ability was created in 2013 budget). However, this is mitigated by provisions in the ACA which keep children on Health Choice for a year at a time.
Gives DHHS the ability to control and spend total Medicaid funds as it sees fit – in conjunction with a Medicaid reform plan.
Providers who want to get reimbursed by Medicaid will have to pay an initial $100 credentialing fee and $100 every three years when they apply for recredentialing. Providers who want to get reimbursed by Medicaid will have to pay an initial $100 credentialing fee and $100 every three years when they apply for recredentialing. Providers who want to get reimbursed by Medicaid will have to pay an initial $100 credentialing fee and $100 every three years when they apply for recredentialing.
Orders Medicaid to cover all adoptive children with special or rehabilitative needs, regardless of family income; to cover independent foster children until they’re 20 and to women with breast or cervical cancer who lack insurance and who meet income guidelines. Raises threshold for paying annual enrollment fee. Orders Medicaid to cover all adoptive children with special or rehabilitative needs, regardless of family income; to cover independent foster children until they’re 20 and to women with breast or cervical cancer who lack insurance and who meet income guidelines. Raises threshold for paying annual enrollment fee.
Increases funding to hospitals by $1M in FY 15-16 and $1.1M in FY 16-17 to make up for loss of the sales tax exemption written into the Senate budget.
Mandates that outpatient hospital services for NC Health Choice be cost settled at 70 percent of allowable costs, same as Medicaid
Increases the state’s cost settlement with Vidant Medical Center to 100 percent of allowable costs. This will cost a total of about $3.4M in annual funds. Vidant is the former Pitt County Medical Center and is the teaching hospital for the medical school at ECU. Increases the state’s cost settlement with Vidant Medical Center to 100 percent of allowable costs. This will cost a total of about $3.4M in annual funds. Vidant is the former Pitt County Medical Center and is the teaching hospital for the medical school at ECU. Increases the state’s cost settlement with Vidant Medical Center to 100 percent of allowable costs. This will cost a total of about $3.4M in annual funds. Vidant is the former Pitt County Medical Center and is the teaching hospital for the medical school at ECU.
Recalculation (rebase) of the cost of Health Choice (the program that allows for children in families that do not qualify for Medicaid, but who also cannot afford health insurance). The rebase anticipates enrollment growth of about 2.3 percent, plus increased utilization and claims. This increases the total budget by 14.2 percent, or $5.52M to a total of $199.2M for FY 2015-16. Recalculation (rebase) of the cost of Health Choice (the program that allows for children in families that do not qualify for Medicaid, but who also cannot afford health insurance). The rebase anticipates enrollment growth of about 2.3 percent, plus increased utilization and claims. This increases the total budget by 14.2 percent, or $5.52M to a total of $199.2M for FY 2015-16 and $202.8M in FY 2016-17
Under the Affordable Care Act, children who qualify for the State Children’s Health Insurance Plan (SCHIP) are being moved to Medicaid and SCHIP is phasing out. The budget realizes fewer receipts from the federal government for SCHIP to the tune of $20.5M. Not a cut so much as a recognition of lost program revenue. Some of this money will be seen in increased federal receipts for Medicaid.
Provides $2M recurring dollars for a new Traumatic Brain Injury Waiver program to cover people with TBI to get enhanced Medicaid services Provides $2M recurring dollars for a new Traumatic Brain Injury Waiver program to cover people with TBI to get enhanced Medicaid services. Same as House. Provides $1M in FY 2015-16 and $2M in 2016-17 for a new Traumatic Brain Injury Waiver program to cover people with TBI to get enhanced Medicaid services.
Provides $2.5M in planning funds for a Medicaid reform program which will “shift risk from the State under a capitated model.” No other details of the reform plan are given. Provides $5M per annum in planning funds for a Medicaid reform program which will “shift risk from the State under a capitated model.” Provides $5M per annum in planning funds for a Medicaid reform program which will “shift risk from the State under a capitated model.”
Adds to Medicaid Contingency Reserve created in the 2014 budget to be used in the case of shortfall.
Adds $225M over two years to Medicaid “Transformation Fund” to be used as program switches from state-run to managed care
Orders LME/MCOs to coordinate and collaborate with CCNC to improve the integration of mental health and physical health services. Orders a report on progress and performance by March, 2016.
Requires LME/MCOs to consolidate to create no more than five organizations.
Requires a joint study by DHHS and the Dept of Public Safety to measure impact of Justice Reinvestment Act on demand for mental health services, measure the impact of mental health needs on local law enforcement and look at how judicial rulings have impacted behavioral health system. Requires a joint study by DHHS and the Dept of Public Safety to measure impact of Justice Reinvestment Act on demand for mental health services, measure the impact of mental health needs on local law enforcement and look at how judicial rulings have impacted behavioral health system. Requires a joint study by DHHS and the Dept of Public Safety to measure impact of Justice Reinvestment Act on demand for mental health services, measure the impact of mental health needs on local law enforcement and look at how judicial rulings have impacted behavioral health system.
Uses $2.1M to create pilot program to study the effects of targeted case management, with a report due in Dec 2017.
Orders DHHS to study the fiscal effect of reinstating visual aid coverage. Orders a report by Oct, 2015. Orders DHHS to study the fiscal effect of reinstating visual aid coverage. Orders a report by Oct, 2015. Orders DHHS to study the fiscal effect of reinstating visual aid coverage for glasses to be made at the Nash Optical Plant (run by Corrections Enterprises). Orders a report by Oct, 2015.
Provides $1M in funding per year to the Office of Administrative Hearings for mediation services tor Medicaid patients in dispute with their providers. Provides $1M in funding per year to the Office of Administrative Hearings for mediation services tor Medicaid patients in dispute with their providers. Provides $1M in funding per year to the Office of Administrative Hearings for mediation services tor Medicaid patients in dispute with their providers.
DHHS will transfer $139M per year to the Dept of the Treasurer to be accounted for as “nontax revenue” from state owned hospitals and facilities. DHHS will transfer $139M per year to the Dept of the Treasurer to be accounted for as “nontax revenue” from state owned hospitals and facilities. DHHS will transfer $139M per year to the Dept of the Treasurer to be accounted for as “nontax revenue” from state owned hospitals and facilities.
Allows Health Choice to set a maximum lifetime limit for benefits. Allows Health Choice to set a maximum lifetime limit for benefits.
Requires Eastern Band of the Cherokee to assume responsibility for any social services, Medicaid, NC Health Choice and all other Medicaid administrative and service functions. EBC must accept oversight of DHHS to administer and supervise all these programs. Requires Eastern Band of the Cherokee to assume responsibility for any social services, Medicaid, NC Health Choice and all other Medicaid administrative and service functions (including food stamps). EBC must accept oversight of DHHS to administer and supervise all these programs.
Provides cost settlement for dental services provided at UNC and ECU at the same reimbursement rate as Medicaid dental services. Sets for conditions of enrollment for mobile dental provider services. Requires any mobile dental provider to show affiliation with a dental practice that is “not mobile”
Allows Medicaid to cover blood sugar testing supplies up to $1.9M in 2015-16 and $2.2M in 2016-17

SOCIAL SERVICES

SOCIAL SERVICES

SOCIAL SERVICES
Reduces funds for State-County Special Assistance by $4M, leaving $125.8M, leaves rates the same: $1,182 for adult care home residents, $1,515 for residents in special care/ dementia units. Reduces funds for State-County Special Assistance by $4M, leaving $125.8M, leaves rates the same: $1,182 for adult care home residents, $1,515 for residents in special care/ dementia units. Reduces funds for State-County Special Assistance by $4M, leaving $125.8M, leaves rates the same: $1,182 for adult care home residents, $1,515 for residents in special care/ dementia units.
Reduces funding for personal services contracts by $9,540 Reduces funding for personal services contracts by $9,540
Extends the moratorium on creating new licenses for in-home aide services to June 2017. Orders a study on the state-wide demand and supply by March, 2016 No mention of in-home aide moratorium.
Extends moratorium on special care unit (dementia care) licenses to June 2017, orders a study on the state-wide demand and supply due March, 2016. Extends moratorium on special care unit (dementia care) licenses to June 2017, orders a study on the state-wide demand and supply due March, 2016. Extends the moratorium on creating new licenses for special care unit services to June 2017. Orders a study on the state-wide demand and supply by March, 2016. Excepts areas of the state that have been designated by the DHHS Secretary as a shortage area.
Creates licensure process for overnight respite care facilities (see bloc grants). Creates licensure process for overnight respite care facilities (see bloc grants).
Increases funding for foster care by $4.5M. Also provides $50,000 in funding to raise age to 19 for youth in foster care, adding one new position and $1.3M in funding to support a demonstration project to improve outcomes for youth transitioning out of foster care (this is all contingent on the passage of legislation making its way through the General Assembly). Increases funding for foster care to raise age to 21 for youth in foster care, sets out rates for foster families housing these older youth, adds enhanced rates for parents of foster youth with HIV, requires the state and the county or residence to contribute 50 percent of the non-federal share of funding to meet these enhanced rates. (this is all contingent on the passage of legislation making its way through the General Assembly). Adds $12M to cover costs of increased foster care caseload. Increases funding for foster care to raise age to 21 for youth in foster care, sets out rates for foster families housing these older youth, adds enhanced rates for parents of foster youth with HIV, requires the state and the county or residence to contribute 50 percent of the non-federal share of funding to meet these enhanced rates. (this is all contingent on the passage of legislation making its way through the General Assembly). Adds $12M to cover costs of increased foster care caseload.
Allows kids to continue in foster care until 21, even if they have previously opted out of foster care before they were 18. Provides $50,000 in first year and $2M in second year of biennium to raise the age to 21. Gives the state Commission on Mental Health, Developmental Disabilities and Substance Abuse Services oversight for this expansion, and creating any needed rules. Allows kids to continue in foster care until 21, even if they have previously opted out of foster care before they were 18. Provides $50,000 in first year and $1M in second year of biennium to raise the age to 21. Gives the state Commission on Mental Health, Developmental Disabilities and Substance Abuse Services oversight for this expansion, and creating any needed rules.
Reduces funds for State-County Special Assistance by $4M, leaving $125.8M, leaves rates the same: $1,182 for adult care home residents, $1,515 for residents in special care/ dementia units. Reduces funds for State-County Special Assistance by $4M, leaving $125.8M, leaves rates the same: $1,182 for adult care home residents, $1,515 for residents in special care/ dementia units. Reduces funds for State-County Special Assistance by $4M, leaving $125.8M, leaves rates the same: $1,182 for adult care home residents, $1,515 for residents in special care/ dementia units.
DHHS is ordered to come up with a plan for extending foster care to 21 years old and report to NCGA oversight committee by October 1, 2015. DHHS is ordered to come up with a plan for extending foster care to 21 years old and report to NCGA oversight committee by March 2016.
Provides $400K in funding for child advocacy centers Provides $400K in funding for child advocacy centers for FY 2015-16 only
Allocates $75,000 annually to pay for the National Federation of the Blind Newsline, an electronic reading service for the blind. Allocates $75,000 annually to pay for the National Federation of the Blind Newsline, an electronic reading service for the blind.
Reduces funding for personal services contracts by $9,250
Funds Intensive Family Preservation Services funding and provides money to do enhance performance fo the program by adding provisions for six month follow-up, cost-benefit data, data on long term benefits and info on the interventions used. Funds Intensive Family Preservation Services funding and provides money to do enhance performance fo the program by adding provisions for six month follow-up, cost-benefit data, data on long term benefits and info on the interventions used. Funds Intensive Family Preservation Services funding and provides money to do enhance performance fo the program by adding provisions for six month follow-up, cost-benefit data, data on long term benefits and info on the interventions used.
Creates Foster Care Family Act, which outlines new standards for “reasonable and prudent” parenting, sets out caregiver standards and oversight standards. Also sets out new standards for permanent living arrangements for older foster children. This was done in a separate statute.
Allows kids 16 and older in foster care to purchase auto insurance, places responsibility for payment of insurance and any damages incurred if the child has an accident on the foster child.
Mandates that some foster care budget dollars go to guardianship assistance program, to reimburse legal guardians for room and board a the same rate as in the foster care program. . Mandates that some foster care budget dollars go to guardianship assistance program, to reimburse legal guardians for room and board a the same rate as in the foster care program. .Mandates that kids in the program can continue services until they’re 21, if they choose, only if they’re in school or vocational education, employed at least half time, or disabled and unable to attend school/ work. Mandates that some foster care budget dollars go to guardianship assistance program, to reimburse legal guardians for room and board a the same rate as in the foster care program. .Mandates that kids in the program can continue services until they’re 21, if they choose, only if they’re in school or vocational education, employed at least half time, or disabled and unable to attend school/ work. Provides $100,000 in adoption assistance for youth adopted after the age of 16 in FY 2016-17
Provides funding ($339,493) to administer the NC REACH program that targets foster children who wish to attend post-secondary school. Provides funding ($339,493) to administer the NC REACH program that targets foster children who wish to attend post-secondary school. Provides funding ($339,493) to administer the NC REACH program that targets foster children who wish to attend post-secondary school.
Creates a Foster Care Transitional Living Initiative Fund that will provide transitional living services for kids 17-21 who are aging out of the foster care system. The Fund is ordered to raise matching funds from private entities, measure the impact and evaluate the effectiveness of the services provided. Creates a Foster Care Transitional Living Initiative Fund that will provide transitional living services for kids 17-21 who are aging out of the foster care system. The Fund is ordered to raise matching funds from private entities, measure the impact and evaluate the effectiveness of the services provided. Provides $3M over the biennium.
Creates a Permanency Innovation Initiative Oversight Committee with 12 members to oversee changes and administration of foster care and adoption programs. Creates a Permanency Innovation Initiative Oversight Committee with 12 members to oversee changes and administration of foster care and adoption programs.
Allows the Division of Social Services to retain 15 percent of federal dollars for administration and to improve effectiveness of services to children supported by the state. Also orders the department to report findings of a statewide evaluation to the General Assembly by March 2016. Also requires county child support service programs to do evaluation of how federal dollars get spent, and report findings to NCGA by Nov. 2015. Allows the Division of Social Services to retain 15 percent of federal dollars for administration and to improve effectiveness of services to children supported by the state. Also orders the department to report findings of a statewide evaluation to the General Assembly by March 2016. Also requires county child support service programs to do evaluation of how federal dollars get spent, and report findings to NCGA by Nov. 2015. Allows the Division of Social Services to retain 15 percent of federal dollars for administration and to improve effectiveness of services to children supported by the state. Also orders the department to report findings of a statewide evaluation to the General Assembly by March 2016. Also requires county child support service programs to do evaluation of how federal dollars get spent, and report findings to NCGA by Feb 2016
Requires DHHS to design and prepare a Medicaid waiver for serviing children with Serious Emotional Disturbance in home and community based settings, and submit a report to the HHS Oversight committee by Dec. 2015.

DIVISION OF PUBLIC HEALTH

DIVISION OF PUBLIC HEALTH

DIVISION OF PUBLIC HEALTH
Eliminates the Office of Minority Health of the Division of Public Health in DHHS to save $3,144,108. Six positions eliminated. Transfers the funds to the competitive block grant administered by the Division of Central Management and Support Keeps Office of Minority Health budget at $3.3M but takes $2.76M of that from Preventive Health Services Block Grant funds to be used for community health disparities grants.
Keeps AIDS drug assistance program budget at $47.8M. Recurring extra drug rebate money of $6.3M goes back to state coffers Reduces annual funding for AIDS Drug Assistance Program by $6,268,646 thanks to additional funding from drug rebate receipts. Maintains funds available for AIDS pharmaceuticals at $47,844,707. Reduces annual funding for AIDS Drug Assistance Program by $6,268,646 thanks to additional funding from drug rebate receipts. Maintains funds available for AIDS pharmaceuticals at $47,844,707.
Reduces recurring funding for university and personal services contracts by $70,072 Takes away $70,072 in recurring funds for university and personal services contracts. Funding available for this purpose remains at $3,551,989 Takes away $70,072 in recurring funds for university and personal services contracts. Funding available for this purpose remains at $3,551,989
Keeps Quitline’s budget at $1.2M. $100K of recurring extra Medicaid receipt money goes back to the state Keeps Quitline’s budget at $1.2M. $100K of recurring extra Medicaid receipt money goes back to the state Keeps Quitline‘s budget at $1.2M. $100K of recurring extra Medicaid receipt money goes back to the state
Eliminates the Physical Activity and Nutrition Branch in DHHS to save $266,312. Transfers the money to the competitive block grant administered by the Division of Central Management and Support. Eliminates six positions down to 2.3 full time positions. Budgets $1.24M of federal Preventive Health Services Block Grant funds to Physical Activity and Nutrition Program
Renames Office of Rural Health and Community Care as the “Rural Health Section” and moves it into the Division of Public Health. Renames Office of Rural Health and Community Care as the “Office of Rural Health”
Establishes a competitive grant system to fund activities done by Office of Minority Health, Physical Activity and Nutrition Branch (see grants section of table): – $14.2 M for competitive grants bidded on by not for profits for new grants
– $3.45M plus $2.7M from the Preventive Health Services Block Grant, to continue grants already in place to reduce health disparities
– $586,354 plus $1.2M from the Preventive Health Services Block Grant to continue grants already in place for physical health and nutrition-related activities
Instructs Department of Public Safety to work with DHHS to buy AIDS drugs for prisoners in a way that allows for federal matching funds for the drugs Instructs Department of Public Safety to work with DHHS to buy AIDS drugs for prisoners in a way that allows for federal matching funds for the drugs Instructs Department of Public Safety to work with DHHS to buy AIDS drugs for prisoners in a way that allows for federal matching funds for the drugs
Increases the total funding for the Office of the Chief Medical Examiner to $8.6M in FY 2015-16 and $10.4M in FY 2016-17. See specific actions below: Increases the total funding for the Office of the Chief Medical Examiner to $8.6M in FY 2015-16 and $10.4M in FY 2016-17. See specific actions below:
Earmarks $2.2M of future money, nonrecurring, to replace and upgrade the Medical Examiner information system Earmarks $2.2M of future money, nonrecurring, to replace and upgrade the Medical Examiner information system. Earmarks $2.2M of future money, nonrecurring, to replace and upgrade the Medical Examiner information system.
Requires new annual continuing education training for medical examiners. Requires new annual continuing education training for medical examiners.
Provides $100K in recurring training money to implement mandatory annual training for county medical examiners and nonrecurring funds of $400K to replace the Office of the CME’s outdated and obsolete equipment, increasing the total budget of Office of CME to $8.7M. The training will include instruction regarding sudden unexplained death from epilepsy. Provides $100K in recurring training money to implement mandatory annual training for county medical examiners and nonrecurring funds of $400K to replace the Office of the CME’s outdated and obsolete equipment, increasing the total budget of Office of CME to $8.7M. The training will include instruction regarding sudden unexplained death from epilepsy. Provides $100K in recurring training money to implement mandatory annual training for county medical examiners and nonrecurring funds of $400K to replace the Office of the CME’s outdated and obsolete equipment, increasing the total budget of Office of CME to $8.7M. The training will include instruction regarding sudden unexplained death from epilepsy.
Increases the fee paid to county medical examiners to $200 per case. Increases the fee paid to county medical examiners to $250 per case. Increases the fee paid to county medical examiners to $200 per case.
Eliminates $1,080,000 in recurring funding by budgeting revenue generated from an autopsy fee increase and eliminates the $400 supplement paid for contractor-performed autopsies. The Office of the Chief Medical Examiner will pay an increased rate for contracted autopsies that are not billed to counties, at a total cost of $418.5K. This will save $661,500 annually. Eliminates $1,080,000 in recurring funding by budgeting revenue generated from an autopsy fee increase and eliminates the $400 supplement paid for contractor-performed autopsies. The Office of the Chief Medical Examiner will pay an increased rate for contracted autopsies that are not billed to counties, at a total cost of $418.5K. This will save $661,500 annually.
Allots $250K in recurring funds to support one Forensic Pathologist Fellowship each year at East Carolina and Wake Forest Universities, who will perform autopsies at the State’s regional autopsy centers. This increases the funds available for purchased services to $3,651,250. Also increases the fee for an autopsy from $1,250 to $1,750. Allots $250K in recurring funds to support one Forensic Pathologist Fellowship each year at East Carolina and Wake Forest Universities, who will perform autopsies at the State’s regional autopsy centers. Allots $250K in recurring funds to support one Forensic Pathologist Fellowship each year at East Carolina and Wake Forest Universities, who will perform autopsies at the State’s regional autopsy centers.
Budget anticipates more money received annually due to increased fee for autopsies, totaling $1,813,500. Effective July 1, 2015, the autopsy fee will increase from $1,250 to $2,800. Budget anticipates $585,000 more money received annually due to increased fee for autopsies. Effective July 1, 2015, the autopsy fee will increase from $1,250 to $2,800.
Allots $400K in recurring funds to increase the rate paid for transporting bodies for death investigations or to the Office of Chief Medical Examiner autopsy centers. Allots $400K in recurring funds to increase the rate paid for transporting bodies for death investigations or to the Office of Chief Medical Examiner autopsy centers.
Provides $1,050 supplement paid to counties to cover the cost counties will be billed for autopsies ($1,750) and what the total cost for performing autopsies ($2,800)
Creates funding for 12 grants to be used in projects aimed at reducing health disparities in non-white communities, mandates the grants be geographically dispersed, and sets a limit for the amount of overhead funds a program can spend. The department will submit a status report to the NCGA in Oct 2017. Creates funding for 12 grants to be used in projects aimed at reducing health disparities in non-white communities, mandates the grants be geographically dispersed, and sets a limit for the amount of overhead funds a program can spend. The department will submit a status report to the NCGA in Oct 2017.
Mandates that at least 5 percent of grants be awarded to new organizations which did not receive funding in the prior grant process.
Allocates $350,000 per year to Big Brothers, Big Sisters for mentoring, the organization will have to participate in the competitive grants process after FY 2017
Deletes $135,000 of funding to Planned Parenthood for two adolescent pregnancy/ parenting programs.
Provides $106,587 in annual funds and $368,000 in one-time funding to develop and implement an Electronic Death Records system (currently, all death certificates are processed by hand). Much, if not all, of the costs of this system will be covered by receipts. Provides $106,587 in annual funds and $368,000 in one-time funding in FY 2015-16 and $106,587 in annual funds and $1,331,500 in one-time funding in FY 2016-17 to develop and implement an Electronic Death Records system (currently, all death certificates are processed by hand). Much, if not all, of the costs of this system will be covered by receipts.
Provides $175K in nonrecurring funds for time-limited Vital Records Section customer service staff during the development and implementation of the Electronic Death Records System, increasing the Section’s budget by 4% to $4,552,729
Budgets $110K in recurring funds to provide rabies drugs at the State Public Health Laboratory to indigent persons who have been exposed to rabid animals, increasing the funds available for drug supplies to $280,466 Budgets $110K in recurring funds to provide rabies drugs at the State Public Health Laboratory to indigent persons who have been exposed to rabid animals, increasing the funds available for drug supplies to $280,466
Provides $2.5M in recurring funds and $2.5M in nonrecurring funds for a competitive block grant process for county health departments to apply for funds to use to increase access to prenatal care and improve birth outcomes Provides $2.5M in recurring funds and $2.5M in nonrecurring funds for a competitive block grant process for county health departments to apply for funds to use to increase access to prenatal care and improve birth outcomes
Allots $900K in annual funds for home visiting services provided by the Nurse Family Partnership Program, making the total funds available for the program $1.4M Allots $509,018 in block grant funds for the Nurse Family Partnership Program. Allots $900K in annual funds for home visiting services provided by the Nurse Family Partnership Program, making the total funds available for the program $1.4M
Provides $465K in one-time funding to sustain the Perinatal Quality Collaborative of North Carolina (PQCNC) while it transitions between 2015 and 2017 to become fully receipt-suppported effective July 1, 2017 Provides $465K in one-time funding to sustain the Perinatal Quality Collaborative of North Carolina (PQCNC) while it transitions between 2015 and 2017 to become fully receipt-suppported effective July 1, 2017
Orders that funds allocated for school nurses not be used for other purposes and that school nurses not be used to teach any academic classes Orders that funds allocated for school nurses not be used for other purposes and that school nurses not be used to teach any academic classes Orders that funds allocated for school nurses not be used for other purposes and that school nurses not be used to teach any academic classes
Provides a raise for school nurses paid for by state dollars, gives DHHS flexibility to adjust health care worker salaries in state facilities closer to private market rates. Provides a raise for school nurses paid for by state dollars, gives DHHS flexibility to adjust health care worker salaries in state facilities closer to private market rates.
Increase fee for new born screening from $19 to $24 for lab tests, used to offset the cost of the Newborn Screening Program, which costs $440,000
Provides poison control center funds $1M

MENTAL HEALTH, DEVELOPMENTAL DISABILITIES AND SUBSTANCE ABUSE SERVICES

MENTAL HEALTH, DEVELOPMENTAL DISABILITIES AND SUBSTANCE ABUSE SERVICES

MENTAL HEALTH, DEVELOPMENTAL DISABILITIES AND SUBSTANCE ABUSE SERVICES
In the case that the state budget is not completed by the first day of the fiscal year, LMEs will receive 1/12th of their budget to keep them whole. That amount will be subtracted from their total state appropriation at year’s end. In the case that the state budget is not completed by the first day of the fiscal year, LMEs will receive 1/12th of their budget to keep them whole. That amount will be subtracted from their total state appropriation at year’s end. In the case that the state budget is not completed by the first day of the fiscal year, LMEs will receive 1/12th of their budget to keep them whole. That amount will be subtracted from their total state appropriation at year’s end.
Eliminates state funding of 2 percent to LME/MCOs to create risk reserve. Reduces single stream funding for LME/MCOs by $185,604,653 in each fiscal year. Orders LME/MCOs to use cash reserves to maintain service effort. Also requires LME/MCOs to fund risk reserves out of cash reserves. DHHS will stop providing the additional 2 percent for risk reserves once LMEs have accumulated 15 percent of annual premiums in reserve. Reduces single stream funding for LME/MCOs by $110,808,752 in FY 15-16 and $152,850,133 in FY 16-17 divided among the nine LME/MCOs. Orders LME/MCOs to use cash reserves to maintain service effort. If there’s money left over from Medicaid at the end of the FY, then $30M will be returned to LME/MCOs proportionally.
Provides $7.8M in FY 2015-16 and $15.6M in FY 2016-17 to fund federal Dept of Justice settlement to create housing, support and other services for people with mental illness, especially those currently or formerly living in adult care homes.
Funds the ABLE Act, which allows for families to set aside up to $100,000 in a 529 account for use by disabled family members. Appropriates $835,000 in FY 2015-16 and $595,000 in FY 2016-17 out of the $850,000/ year requested by the Treasurer’s office to administer the Act. Funds the ABLE Act, which allows for families to set aside up to $100,000 in a 529 account for use by disabled family members. Appropriates $835,000 in FY 2015-16 and $595,000 in FY 2016-17 out of the $850,000/ year requested by the Treasurer’s office to administer the Act. Appropriates $215,000 in annual funds and $250,000 in one time money in FY 2015-16 and $595,000 in FY 2016-17 out of the $850,000/ year requested by the Treasurer’s office to administer the Act.
Allows NC Housing Finance Authority to use funds to recruit people willing to rent to people with disabiilties.
Requires LME/ MCOs to transfer their operating cash to risk reserve and discontinues state contribution to risk reserves. Reduces state contribution $8.4M in FY 2015-16 and $17.2M in FY 2016-17 Requires LME/ MCOs to transfer a total of $17.2M to NC Medicaid / year, the amount paid by each LME to be determined by their size and cash on hand.
Takes away $243,886 in annual funding personal service contracts, leaving $535,015 available for miscellaneous contractual services Takes away $243,886 in annual funding personal service contracts, leaving $535,015 available for miscellaneous contractual services
Provides $225K in nonrecurring funds to pilot the use of EMS departments to assess and trasnport persons with a mental health or substance abuse crisis to non-hospital settings, which will expand the existing pilot from 1 to 14 sites and complete a study after one year. This funding increases the pilot budget from $60K to $285K Provides $350,000 in nonrecurring funds to pilot the use of EMS to transport non-emergent patients to facilities other than emergency rooms. Instructs NC Office of Emergency Medical Services to set the standards. New Hanover county EMS gets one $210,000 for one pilot program, $70,000 for each of two other programs in remaining sites. Orders study and report due June 2016. Provides $350,000 in nonrecurring funds to pilot the use of EMS to transport non-emergent patients to facilities other than emergency rooms. Instructs NC Office of Emergency Medical Services to set the standards. New Hanover county EMS gets one $210,000 for one pilot program, $70,000 for each of two other programs in remaining sites. Orders study and report due June 2016.
$10.6M in nonrecurring funds will be allotted for the new Broughton Hospital replacement facility scheduled to open in December 2016. These funds will cover technology infrastructure, furniture and equipment $16.6M in one-time funds will be allotted for the new Broughton Hospital replacement facility scheduled to open in December 2016. These funds will cover technology infrastructure, furniture and equipment
Allots $2.8M in recurring -but increasing in 2016-17 – funds to offset inflationary increases in utilities, food and other costs at State-operated healthcare facilities, increasing the total funds available for the facilties to $897,841,574 Allots $2.8M in recurring -but increasing in 2016-17 – funds to offset inflationary increases in utilities, food and other costs at State-operated healthcare facilities, increasing the total funds available for the facilties to $897,841,574
Provides $5M in recurring funds to offset the loss of Medicaid receipts, increased indigent caseloads and other factors that have contributed to chronic budget shortfalls at Central Regional Hospital, increasing the facility’s total available funds to $223.9M
Provides $4.9M in annually recurring funds in a three-way contract to increase the number of community hospital beds that may be purchased to provide psychiatric inpatient treatment services from 165 to 180, increasing funding by 14% to $43,047,144. Distributes these beds across the state’s geographic regions. Provides $4.9M in annually recurring funds in a three-way contract to increase the number of community hospital beds that may be purchased to provide psychiatric inpatient treatment services from 165 to 180, increasing funding by 14% to $43,047,144. Distributes these beds across the state’s geographic regions. Provides $4.9M in annually recurring funds in a three-way contract to increase the number of community hospital beds that may be purchased to provide psychiatric inpatient treatment services from 165 to 180, increasing funding by 14% to $43,047,144. Distributes these beds across the state’s geographic regions.
Allows state health officials to move management of these community hospital beds from one LME to another if the first LME is not effectively managing them. Provides $800K in additional funds in FY 2015-16 and $1.6M in FY 2016-17 for people with intellectual/ developmental disabilities to get residential living, day services, supported employment, and family support services.
Orders that as much as $25M from Trust Fund for Mental Health (which comes from money from the sale of Dorothea Dix property) go to creation of a three-year pilot program to convert unused beds in rural hospitals into shsort-term psychiatric beds, restricts that funding to this purpose only. Orders DHHS to inspect each facility at least every six months and orders an annual status report to the Legislature. Creates separate $50M Dorothea Dix Hospital Property Fund to be allocated or expended “only upon an act of appropriation by the NCGA” and shall not be subject to limitations on other trust funds in DHHS. Creates separate $50M Dorothea Dix Hospital Property Fund to be allocated or expended “only upon an act of appropriation by the NCGA” and shall not be subject to limitations on other trust funds in DHHS.
Orders creation of a memorial to Dix and educate people about her work. Options to be presented to the NCGA by April 2016. Orders that as much as $25M from Trust Fund for Mental Health (which comes from money from the sale of Dorothea Dix property) go to creation of a three-year pilot program to convert unused beds in rural hospitals into shsort-term psychiatric beds, restricts that funding to this purpose only.
$7.8M in recurring funding to cover the US Department of Justice settlement that provides for the development housing options for people with mental health disabilities $7.8M in recurring funding to cover the US Department of Justice settlement that provides for the development housing options for people with mental health disabilities
Provides $2.3M in recurring funds to add a fourth NC START (Systematic, Therapeutic, Assessment, Resrouces and Treatment) Team to provide services to children and adolescents with intellectual or development disabilities, increasing the total funds available for child and adult NC START services from $2,437,207 to $4,753,207 Provides $1.54M in recurring funds to NC START (Systematic, Therapeutic, Assessment, Resrouces and Treatment) Teams to provide services to children and adolescents with intellectual or development disabilities, increasing the total funds available for child and adult NC START services from $2,437,207 to $3,981,207
Allots $1.86M in annual funds to increase the number of TASC (Treatment Alternatives for Safer Communities) case managers who provide substance abuse assessment and referral services to criminal offenders who are maintained in the community instead of sentened to prison or those who have been released form prison and are under a probation officer’s supervision, incrasing the TASC budget by 35% from $5.362M to $7.222M Allots $1.86M in annual funds to increase the number of TASC (Treatment Alternatives for Safer Communities) case managers who provide substance abuse assessment and referral services to criminal offenders who are maintained in the community instead of sentened to prison or those who have been released form prison and are under a probation officer’s supervision, incrasing the TASC budget by 35% from $5.362M to $7.222M
Allots $2M in one-time funds to establish additional behavioral health urgent care centers and facility-based crisis centers around the State
Gives $350K in one-time funding and establishes $134K in annually recurring funding to develop and operate a psychiatric bed registry to provide real-time information on the number of child, adolescent and adult beds available at each licensed inpatient facility in the State Gives $350K in one-time funding and establishes $134K in annually recurring funding to develop and operate a psychiatric bed registry to provide real-time information on the number of child, adolescent and adult beds available at each licensed inpatient facility in the State
Orders a report from DHHS on the status of multiplicative auditing and monitoring of behavioral health agencies. Provides $450,000 in annual funds for State Auditor to do audits of DHHS. Money comes out of DHHS budget.
Creates new services for people with traumatic brain injury (different from waiver services above). $359,218 goes to the Brain Injury Association to provide services, another $796,934 to residential programs for people with TBI and $1,216,934 in individual services, such as home modifications or transportation, etc. Creates new services for people with traumatic brain injury (different from waiver services above). $359,218 goes to the Brain Injury Association to provide services, another $796,934 to residential programs for people with TBI and $1,216,934 in individual services, such as home modifications or transportation, etc. Creates new services for people with traumatic brain injury (different from waiver services above). $359,218 goes to the Brain Injury Association to provide services, another $796,934 to residential programs for people with TBI and $1,216,934 in individual services, such as home modifications or transportation, etc.
Sets out intent to end state appopriations for state-operated Alcohol and Drug Abuse Treatment Centers, moves that money to LME/MCOs to manage and purchase substance abuse treatment services, first from the ADATCs and then from “any qualified provider” Sets out intent to end state appopriations for state-operated Alcohol and Drug Abuse Treatment Centers, moves that money to LME/MCOs to manage and purchase substance abuse treatment services, first from the ADATCs and then from “any qualified provider”
Eliminates $37M general fund appropriation for ADATCs and sets out a schedule for facilities to become completely receipt supported. Allocates that money to LME/MCOs to pay for alcohol and drug treatment services
Closes Wright School by Sept 2015. Orders report on duplicative auditing in the Division of Mental Health, Developmental and Substance Abuse Services licensed facilities.
Allocates $25,000 for naloxone to be distributed to the NC Harm Reduction Coalaition, and $25,000 for naloxone to go to law enforcement agencies. Allocates $25,000 for naloxone to be distributed to the NC Harm Reduction Coalaition, and $25,000 for naloxone to go to law enforcement agencies.
Orders all medical licensing boards to accept NC Medical Board’s policies on Use of Opiates for the Treatment of Pain; also requires continuing edutation on abuse of opiates for licensed medical professionals. Orders all medical licensing boards to accept NC Medical Board’s policies on Use of Opiates for the Treatment of Pain; also requires continuing edutation on abuse of opiates for licensed medical professionals.
Adds Drug Enforcement Agency and NC Health Info Exchange to access to controlled substances reporting system access. Sets out funding for CSRS, orders DHHS to apply for grant to establish connection to PMP Interconnect system that allows for interstate tracking of controlled substance users. Allows for Brandeis U Center for Excellence access to CSRS for research and monitoring purposes. Adds Drug Enforcement Agency and NC Health Info Exchange to access to controlled substances reporting system access. Sets out funding for CSRS, orders DHHS to apply for grant to establish connection to PMP Interconnect system that allows for interstate tracking of controlled substance users. Allows for Brandeis U Center for Excellence access to CSRS for research and monitoring purposes.
Orders creation of Prescription Drug Abuse Advisory committee and orders creation of statewide strategic plan to reduce drug abuse. Orders creation of Prescription Drug Abuse Advisory committee and orders creation of statewide strategic plan to reduce drug abuse.

CHILDREN’S SERVICES

CHILDREN’S SERVICES

CHILDREN’S SERVICES
Total availability for NC Pre-K is $144.2M Total availability for NC Pre-K is $141.5M Total availability for NC Pre-K is $144.25M
$5m recurring increase for NC Pre-K (makes the 2014-15 increase permanent) $2.3m recurring increase for NC Pre-K (cuts approx 520 slots from 14-15) $5m recurring increase for NC Pre-K (makes the 2014-15 increase permanent)
Increases the funding from the NC Education Lottery for NC Pre-K to $2.7M No mention of lottery funds. Increases the funding from the NC Education Lottery for NC Pre-K to $2.7M
Children’s Health Initiative: To improve children’s health by investing in programs with a strong evidence-base that provide good return on investment and improved outcomes for infants and children. Establishes DHHS as the lead agency, mandates the School of Public Health at UNC-Chapel Hill to statewide comprehensive plan, perform a review of all programs as they get implemented. To do this, the budget allocates: Children’s Health Initiative: To improve children’s health by investing in programs with a strong evidence-base that provide good return on investment and improved outcomes for infants and children. Establishes DHHS as the lead agency, mandates the School of Public Health at UNC-Chapel Hill to statewide comprehensive plan, perform a review of all programs as they get implemented. To do this, the budget allocates:
– High-Risk Maternity Clinic $375,000 in one time funds High-Risk Maternity Clinic $375,000 in recurring annual funds
– Maternal and Child Health Contracts: $2,847,094 one time funds – Maternal and Child Health Contracts: $2,472,094 one time funds
– Healthy Beginnings: $170,779 one time funds – Healthy Beginnings: 2 contracts = $396,025 in one time funds
– Pregnancy Care Case Management: $300,901 in one time funds – Pregnancy Care Case Management: $300,901 in one time funds
– Maternal, Infant and Early Childhood Home Visiting: $425,643 one-time funds – Maternal, Infant and Early Childhood Home Visiting: $425,643 one-time funds
– Positive Parenting Program (Triple P): $828,233 one time funding – Positive Parenting Program (Triple P): $828,233 one time funding
– NC Perinatal and Maternal Substance Abuse Initiative: $2,729,316 in one-time funding – NC Perinatal and Maternal Substance Abuse Initiative: $2,729,316 in one-time funding
– Perinatal Substance Abuse Specialist: $45,000 one time funding – Perinatal Substance Abuse Specialist: $45,000 one time funding
– Residential Maternity Homes: $375,000 one time funding Provides $925,000 in recurring funding for maternity homes.
– Baby Love Plus: $1,156,915 in federal funds – Baby Love Plus: $1,156,915 in federal funds (subject to a review)
– Young Families Connect: $1,027,528 in federal funds – Young Families Connect: $1,027,528 in federal funds (subject to a review)
Removes non-parent relative caretakers from income eligibility Removes non-parent relative caretakers from income eligibility Removes non-parent relative caretakers from income eligibility
Reinstates the pro-rated parent fee for child care subsidy for children in part time child care (50 percent) and changes income eligibility for children birth–3rd grade to 200% of the Federal Poverty Level (FPL), Children 4th grade-12 years old remain eligible at 133% of FPL Reinstates the pro-rated parent fee for child care subsidy and changes income eligibility for children birth–3rd grade to 200% of the Federal Poverty Level (FPL), Children 4th grade-12 years old remain eligible at 133% of FPL Reinstates the pro-rated parent fee for child care subsidy for children in part time child care (75 percent) and changes income eligibility for children birth–5-years-old to 200% of the Federal Poverty Level (FPL), Children 6-12 years old remain eligible at 133% of FPL
No mention of tier 1 & 2 counties in subsidy rate changes. Dedicates $4.2m in FY 2015-16 and $5m in FY 2016-17 to increase subsidy reimbursements to the 2013 market rate for children birth-2 in 3-5 star centers in tier 1 and tier 2 counties Dedicates $3m in FY 2015-16 and $6m in FY 2016-17 to increase subsidy reimbursements to the 2013 market rate for children birth-2 in 3-5 star centers in tier 1 and tier 2 counties
Sets out more stringent guidelines for determining a county’s subsidy allocation, based on prior year expenditures. Creates complicated guidelines for determining a county’s subsidy allocation based on census data, prior allocations, market rates, etc.
Provides funding for Child Treatment Program training and allocates funding to create a database of program graduates Provides funding for Child Treatment Program training and allocates funding to create a database of program graduates Provides funding for Child Treatment Program training and allocates funding to create a database of program graduates
Creates the Office of Program Evaluation Reporting and Accountability within DHHS. This Office would be responsible for leading a partnership with PEW-MacArthur trust to bring Results First to North Carolina Department of Defense-certified child care centers may receive child care subsidy. NAEYC accredited centers are to be reimbursed at the 5 star rate, all other DOD-certified centers shall be reimbursed at the 4 star rate, Department of Defense-certified child care centers may receive child care subsidy. NAEYC accredited centers are to be reimbursed at the 5 star rate, all other DOD-certified centers shall be reimbursed at the 4 star rate,
DOD certified child care centers may participate in state-subsidized child care programs, provided state funds are only a supplement to funding, and do not replace federal DOD funding. DOD certified child care centers may participate in state-subsidized child care programs, provided state funds are only a supplement to funding, and do not replace federal DOD funding.
Sets goals for the NC Partnership for Children that the statewide partnerships focus more on evidence-basaed programs to increase child literacy, improve child health, assist parents and improve and maintain the quality in 4- and 5-star rated facilities. Sets cap for administration spending at 8 percent and requires local partnerships to raise 100 percent matching funds to state dollars. Places a number of restrictions on local Smart Start organizations: reduces administration cap to 7.75 percent in FY2015-16 and 7.5 percent in FY 2016-17; increases required amounts local Smart Start programs are required to raise and reduces amount to be used on central administration to 3.25 percent, also requires local partnerships to raise 100 percent matching funds to state dollars. Sets goals for the NC Partnership for Children that the statewide partnerships focus more on evidence-basaed programs to increase child literacy, improve child health, assist parents and improve and maintain the quality in 4- and 5-star rated facilities. Sets cap for administration spending at 8 percent and requires local partnerships to raise 100 percent matching funds to state dollars.
Requires local partnerships to match state funds 100 percent, donations of cash need to be at least 11 percent of state funds, and a maximum of 4 percent of in kind donations for both years of the biennium. Requires local partnerships to match state funds 100 percent, donations of cash need to be at least 12 percent of state funds, and a maximum of 5 percent of in kind donations in the first year and 13 percent cash minimum and 6 percent in kind donations in FY 16-17. Requires local partnerships to match state funds 100 percent, donations of cash need to be at least 12 percent of state funds, and a maximum of 5 percent of in kind donations in the first year and 13 percent cash minimum and 6 percent in kind donations in FY 16-17.
Creates a new legislative oversight subcommittee on early childhood and family support programs. Allocates $300,000 for the Program Evaluation Division to hire a firm to develop the plan to merge Smart Start, NC Pre-K, and Child Care Subsidy. Plan is due March 1, 2016 Creates a new legislative oversight subcommittee on early childhood and family support programs.
Allows for county DSSs to use up to 4 percent of county total child care subsidy for administration. Allows for county DSSs to use up to 4 percent of county total child care subsidy for administration. Allows for county DSSs to use up to 4 percent of county total child care subsidy for administration.
Caps at 30 percent of local partnership funds the money that can be used to expand child care subsidies, unless there’s a “significant” local waiting list for subsidized child care. Then cap can be raised to 50 percent. At least 30 percent of local partnership funds the money that can be used to expand child care subsidies, unless there’s a “significant” local waiting list for subsidized child care. Then cap can be raised to a maximum of 50 percent.
Reduces the Temporary Assistance to Needy Families Block Grant by $5,527,584 (up by $527,584) in order to fund Pre-K. However, eliminates the TANF funding swap for Smart Start. Reduces the Temporary Assistance to Needy Families Block Grant by $5.2M (unchanged from last yr) in one-time funding for Pre-K.
Allows 2 percent of child care subsidy funds to be allocated for fraud detection, up to $80,000 Allows 2 percent of child care subsidy funds to be allocated for fraud detection, up to $80,000 Allows 2 percent of child care subsidy funds to be allocated for fraud detection, up to $80,000

BLOCK GRANTS

BLOCK GRANTS

BLOCK GRANTS
Makes a one-time restoration of money in the Home and Community Care Block Grant, increasing the total by 2 percent [$969,549] to $55M (Division of Aging) Restores money into the Home and Community Care Block Grant, increasing the total by 2 percent [$969,549] to $55M (Division of Aging)
Creates $82,606 in funding to pay salaries for an engineer and a nursing consultant to inspect adult care homes and adult day health facilities which want to be certified to provide overnight respite care. Some of the funds for that program will come from receipts, certification fees and construction fees. Pays for these technical needs in the new progam that comes out of Home and Community Care Block Grant funds Creates $82,606 in funding to pay salaries for an engineer and a nursing consultant to inspect adult care homes and adult day health facilities which want to be certified to provide overnight respite care. Some of the funds for that program will come from receipts, certification fees and construction fees. Sets fee schedule for use of Overnight Respite by different populations (ICF/MR, adult day, etc). Pays for these technical needs in the new progam that comes out of Home and Community Care Block Grant funds and some out of renewal certication fees and other receipts.
With $2.5M allotted in recurring funds (2015-17) and $2.5M in onetime funding, DHHS shall implement a competitive process for local health departments to apply for grants. Selection shall be based on a county’s current health status and their proposal to invest in evidence-based programs. Requires the Secretary to prioritize grant awards to those local health departments that are able to leverage non-State funds in addition to the grant award. Funds to implement this plan will supplement – not replace – existing funds for health and wellness programs and initiatives. With $2.5M allotted in recurring funds (2015-17) and $2.5M in onetime funding, DHHS shall implement a competitive process for local health departments to apply for grants. Selection shall be based on a county’s current health status and their proposal to invest in evidence-based programs. Requires the Secretary to prioritize grant awards to those local health departments that are able to leverage non-State funds in addition to the grant award. Funds to implement this plan will supplement – not replace – existing funds for health and wellness programs and initiatives. With $2.5M allotted in recurring funds (2015-17) and $2.5M in onetime funding, DHHS shall implement a competitive process for local health departments to apply for grants. Selection shall be based on a county’s current health status and their proposal to invest in evidence-based programs. Requires the Secretary to prioritize grant awards to those local health departments that are able to leverage non-State funds in addition to the grant award. Funds to implement this plan will supplement – not replace – existing funds for health and wellness programs and initiatives.
Adds $2.25M of Health Net dollars to the Community Health Grant Program, bringing total up to $7.6M. Money goes to safety-net agencies for this fiscal year, but starting in FY 16-17, agencies must compete for grants. Adds $2.25M of Health Net dollars to the Community Health Grant Program, bringing total up to $7.6M. Money goes to safety-net agencies for this fiscal year, but starting in FY 16-17, agencies must compete for grants. Eliminates NC Health Net program and allocates half of remaining money to Community Health Grants program. Community Health Grants up to $7.5M
Creates new rules for reporting by not for profit contractors for DHHS. Allocates $10.3M in general DHHS funding, plus $3.85 M in funding for not-for-profits to provide human services support for: Continues current regimen for reporting by not for profit contractors for DHHS. Adds requirement that nonprofits provide a match of 15 percent of grant award. Also requires 5 percent of hte grants be rewarded to new grantees/ organizations providing services for: Continues current regimen for reporting by not for profit contractors for DHHS. Creates new reporting requirements for nonprofits. Also requires 5 percent of hte grants be rewarded to new grantees/ organizations. Allows for grants to be made for up to two years. Allocates $10.65M in general DHHS funding, plus $3.85 M in funding for not-for-profits to provide human services support for:
– autism advocacy, support, education and residental services – autism advocacy, support, education and residental services – autism advocacy, support, education and residental services
– residental treatment for people with substance abuse disorders – residental treatment for people with substance abuse disorders – residental treatment for people with substance abuse disorders
– program support for people with severe intellectual and developmental disabilities, mental illness, substance abuse problems or the elderly – program support for people with severe intellectual and developmental disabilities, mental illness, substance abuse problems or the elderly – program support for people with severe intellectual and developmental disabilities, mental illness, substance abuse problems or the elderly
– food distribution for low income people – food distribution for low income people – food distribution for low income people
– services for homeless people – services for homeless people – services for homeless people
– services for people aging out of foster care – services for people aging out of foster care – services for people aging out of foster care
– programs to support wellness, physical activity, and health education – programs to support wellness, physical activity, and health education – programs to support wellness, physical activity, and health education
– enhanced vision screening for school children – providing services and screening for blindness – providing services and screening for blindness
– providing after-school services for apprenticeships or mentoring for at-risk youth – providing after-school services for apprenticeships or mentoring for at-risk youth – providing after-school services for apprenticeships or mentoring for at-risk youth
– $400,000 for services for people with Amyotrophic lateral sclerosis (ALS) – provides services for people with Amyotrophic lateral sclerosis (ALS) – provides services for people with Amyotrophic lateral sclerosis (ALS)
– comprehensive smoking prevention and cessation program that screens and treats tobacco use in pregnant women and postpartum
mothers		 – comprehensive smoking prevention and cessation program that screens and treats tobacco use in pregnant women and postpartum
mothers		 – comprehensive smoking prevention and cessation program that screens and treats tobacco use in pregnant women and postpartum
mothers
– providing long-term (12 month minimum) residential substance abuse services – providing long-term (12 month minimum) residential substance abuse services – providing short-term or long-term (12 month minimum) residential substance abuse services
Allocates $2.4M per year to the Boys and Girls Clubs for programs that improve motivation, performance, self-esttem of youth and reduce gang participation, school dropout and teen pregnancy rates Allocates $2.4M per year to the Boys and Girls Clubs for programs that improve motivation, performance, self-esttem of youth and reduce gang participation, school dropout and teen pregnancy rates
– $500,000 for a program providing short-term residential substance abuse services
– for the upcoming 2 years only, provide $1.3M to support Triangle Residential Options for Substance Abusers (TROSA) – for the upcoming 2 years only, provide $1.63M to support Triangle Residential Options for Substance Abusers (TROSA) after which, the organization will have to apply for funding in the same way of other nonprofits.
Creates grant application process for Health Disparity Related initiatives which limit any given grant to $300,000 to reduce disparities among minorities we re: to heart disease, stroke, diabetes, obesity, asthma, HIV/AIDS, cancer, infant mortality and low birth weight. Also limits grants to 3 year maximum and four grants per any given organization. Limits the amount that can be spent on overhead to 8 percent. – for the upcoming two years, allocates $2.4M to Boys and Girls Clubs, after which, the organization will have to apply for funding in the same way of other nonprofits.
Creates grant application process for statewide Physical Health and Nutrition-related initiatives. Also allows grants for two years.
DHHS shall work with the UNC GIllings School of Global Public Health to establish an evaluation protocol for determining program effectiveness and future funding requirements for local programs. By April 1, 2016, DHHS and the school shall submit a report to the HHS committee on a competitive process for local health departments to apply for State funds. DHHS shall work with the UNC GIllings School of Global Public Health to establish an evaluation protocol for determining program effectiveness and future funding requirements for local programs. By April 1, 2016, DHHS and the school shall submit a report to the HHS committee on a competitive process for local health departments to apply for State funds.