Heard in the Halls is an email service of NAMI North Carolina to provide updates on state legislative and policy issues. Heard in the Halls is produced for community advocates at least monthly and more frequently during sessions of the General Assembly. To be added to the Heard in the Halls list send a message to heard@naminc.org with just "subscribe" (no quotes) in the subject header. Because of the variety of e-mail servers, Heard in the Halls is sent in plain text and as a formatted attachment. Previous issues of Heard in the Halls can be viewed a www.naminc.org

4-21-03

The House passed a $15 billion state budget last Thursday and sent it on to the Senate for consideration. This is the earliest a budget has been passed by the House in the past 20 years. The budget was $65 million less than that proposed by Governor Easley. Despite early proposals to cut the Division of MH/DD/SA and Area Programs by between $20-44 million, the House budget contained NO cuts to the Area Mental Health Programs. Cuts totaling $894,000 were made through the reduction and elimination of a number of contracts with various agencies and educational institutions. The Division of MH/DD/SAS inflation increase also was reduced for non-direct service areas, producing a savings of $3.1 million. The House budget also provided $10 million in one time money for the MH/DD/SA Trust Fund.

The budget was balanced by cutting millions of dollars from programs across state government, particularly in other areas of the Department of Health and Human Services. On the revenue side the House agreed to delay implementation of the sales tax reduction and the reduction in income tax on high earners. $269 million in highway funds and $60 million from the tobacco settlement also were used to balance the budget.

We are very grateful to the HHS Appropriations Committee, the Chairs of the Full Appropriations Committee and members of the House for recognizing the importance of maintaining funding for the MH/DD/SA system, particularly during this time of system reform. Many thanks to everyone who made contacts to support our advocacy-- our advocacy worked! We will provide you with updated information as the Senate begins its budget deliberations.

Because the House was focused on the completing the budget last week, many committee meetings were cancelled. This means that both the Special Assistance bill and the Mental Health/Substance Abuse Parity Bill will be heard tomorrow, Tuesday April 22nd. Please contact legislators today and urge them to support these bills.

The House Health Committee will consider H 170 Tuesday April 22nd. NAMI North Carolina and other organizations have worked with the Rep. Verla Insko, the bill’s sponsor, to develop a committee substitute that addresses concerns in the original bill. If passed, this bill will provide a new option for housing support for many individuals with mental illness. Contact members of the House Health Committee now to:

Click on a name below to send an email and get other contact information:

The Committee Substitute takes a demonstration project that has been studied and successfully piloted and expands it to a statewide, ongoing program. Building on the experience of the demonstration project it:

• Allows individuals who qualify for State/County Special Assistance to use a portion of that payment (no more than 50% of what a licensed facility would receive) in order to remain at home

• Participants must qualify for adult care home level of care as recommended by a physician. In addition, they must have a functional assessment completed by a trained, DSS social worker to determine that they are capable of remaining at home

• Participants income must also be at a level that qualifies them for Medicaid (currently $739/month or less), which is 100% of the federal poverty level

• DSS case managers develop, approve, and monitor a personal care plan that includes how special assistance funds will be used to support a person to remain at home

Choice: Elderly and disabled persons ought to have a choice of where to live. North Carolina is one of only 12 states in the country that require individuals to move into a licensed facility, such as an adult care home, in order to receive Special Assistance payments. Many elderly and disabled individuals want to remain at home and, with a small amount of assistance, are capable of doing so.

Olmstead Decision: The state's current policy on Special Assistance encourages institutionalization, which is in conflict with the recent US Supreme Court Olmstead decision and creates the potential for lawsuits.

It will save money: The demonstration project clearly shows that with a small amount of support individuals are able to remain at home. The average Special Assistance payment to individuals in the demonstration project was $184/month compared with $426/month to those in adult care homes. This resulted in a savings of $2.8 million over what would have been spent had those individuals gone into an adult home. At the same time the demonstration project showed that the quality of life for these individuals was improved.

Local Support: Counties have the option of whether they want to take advantage of this option. The bill does not create a new class of eligible people. Individuals must still meet state qualifications to receive Special Assistance. Anyone applying for Special Assistance must go through the same eligibility determination process. Counties will have cost savings, since the average annual Special Assistance payment to a qualified individual at home is $2,900 less than the average annual payment to those in adult care homes.

For more information on this issue go to:

http://www.naminc.org/PPAgenda/PPA_home.htm

H 654, Representative Martha Alexander’s mental health/ chemical dependency parity legislation, is scheduled to be heard in the House Insurance Committee on Tuesday the 22nd. Under the bill, health plans would be required to provide coverage for mental illness and chemical dependency and that coverage must be on par with physical health coverage. It is critical that the Committee approve the bill in order to meet bill deadlines.

ACTION: Contact members of the Insurance Committee NOW and urge them to pass this legislation. Let them know that:

• Mental illness treatment works!
• Parity coverage IS affordable
• It is time to end discrimination against persons with mental illness!

(For more information about insurance parity go to: http://www.naminc.org/PPAgenda/PPA_insuranceparity.htm )

Click on a name below to send an email message and for other contact information:

REMEMBER: Coalition 2001 Rally Tuesday, May 6th from 8:15-1:00 at the back entrance of the Legislative Office Building.