Thursday, December 8, 2011

Federal Judge Protects the Right of More Than 2,000 North Carolinians to Remain in Their Own Home


Contact: Vicki Smith
Executive Director
Disability Rights North Carolina
Phone (919) 856-2195

Thursday, December 8, 2011

Federal Judge Protects the Right of More Than 2,000 North Carolinians to Remain in Their Own Home

Raleigh, NC – U.S. District Court Judge Terrence Boyle today stopped the State of North Carolina from implementing policy on Medicaid personal care services that he said treats people with similar needs differently and puts North Carolinians “who have been successfully living in their own homes…at risk of segregation, in the form of institutionalization.” The Americans with Disabilities Act (“ADA”) prohibits the unnecessary segregation and unjustified institutional isolation of persons with disabilities. The State is required to provide federally-funded services in “the most integrated setting appropriate to the needs of the individual,” and the Medicaid Act requires that recipients not be treated differently when they have similar levels of need.

In his order granting a preliminary injunction and class certification, Judge Boyle found that plaintiffs offered sufficient evidence that the State’s policy on personal care services violates the Medicaid Act’s requirement to provide comparable services and the ADA’s integration mandate. The policy under review allowed individuals in facilities such as Adult Care Homes to be eligible for personal care services by meeting one set of eligibility requirements and required individuals in the community to meet a far higher standard of need. Under the policy, individuals who would not be eligible for personal care services while living in the community would get the care they needed by entering an Adult Care Home.

Judge Boyle also ruled the plaintiffs were likely to be successful on the claim that the letters sent to the plaintiffs to deny them services failed to comply with due process because the letters “contained verbatim language that failed to provide detailed reasons for the proposed termination” and that this was unlikely to be sufficient for a service that “could be quantified as a ‘brutal need.’” The Due Process Clause of the Constitution requires adequate notice be provided when a Medicaid service is terminated.

In granting the preliminary injunction and motion for class certification, Judge Boyle recognized that the “[l]ack of in-home PCS could result in either serious physical or mental injury or forced entry into institutional settings for many of the named Plaintiffs and members of the class….”

“We are thrilled with Judge Boyle’s decision. He confirmed our position that the State’s policy pushed people toward institutional settings,” says Vicki Smith, Executive Director of Disability Rights NC. “It is our hope that this decision will encourage the State to develop policies that articulate a clear priority to keep people in their homes and community. Such policies will be cheaper and lawful – a double win for the NC taxpayers.”

Plaintiffs were represented by Disability Rights NC, Legal Services of Southern Piedmont, and the National Health Law Program.

# # #
Disability Rights North Carolina is the state’s federally mandated protection and advocacy system for people with disabilities and is a 501(c)(3) nonprofit organization with offices in Raleigh and Asheville. One of the P&A’s primary federal mandates is to protect and advocate against the abuse and neglect of people with disabilities.

Wednesday, December 7, 2011

Occupy Statement

NASW-NC has been working with our National office and many other state chapters to develop a position on the Occupy Movement. The following was approved by our state chapter's board of directors on Dec. 3rd.

National Association of Social Workers, NC Chapter
Position Statement re Occupy Wall Street

As an organization that is committed to social and economic justice and unimpeded access to services for all, the NC Chapter of NASW acknowledges the Occupy Wall Street movement. These protests serve to address America’s “new economy” as a tale of skewed wealth with declining wages, rising debt, and the risk of deep and persistent poverty for many.

Social Workers know that joblessness and economic insecurity contribute to the incidence of mental illness, family violence, suicide, substance abuse, crime, and diminished capacity for healthy family and community functioning. It is this knowledge and experience that gives the social work profession a special responsibility to advocate for income, employment, and social support policies that promote the economic justice and social well-being of all members of society. The NASW-NC Chapter supports social, economic, and political actions to end poverty.

(note: this document is based on NASW's public policy statement on social justice as it appears in Social Work Speaks and the NASW Code of Ethics.)

Tuesday, December 6, 2011

Mental Health Parity Law Brought No Cut in Benefits

Mental Health Parity Law Brought No Cut in Benefits
By Emily P. Walker, Washington Correspondent, MedPage Today
Published: December 02, 2011

WASHINGTON -- Most employers that offered mental health and substance use insurance coverage before the mental health parity law have continued to offer the same coverage, according to a new government report.

The report, from the Government Accountability Office (GAO), examined the extent to which employers provide mental health and substance use treatment to their employees and how that coverage has changed since the passage of the 2008 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act.

That law requires that if a group health plan covers treatment for mental illness or drug or alcohol abuse, the limits and financial requirements for those services can be "no more restrictive" than those that apply to medical and surgical benefits. The law does not require employers to provide mental health and substance use coverage.
Historically, private health insurance plans had provided lower levels of coverage for mental illnesses than for physical illnesses.

According to the GAO report, from 2007 to 2010, about 38% of Americans older than 12 who needed treatment for substance use disorders didn't receive it because of lack of coverage and prohibitive costs.

The GAO surveyed 168 employers with at least 50 employees about their most popular health plans for the year of the survey and what the most popular plan was in 2008, a year before the mental health parity law went into effect. The survey also examined what sort of benefits were excluded in 2008 and not excluded in 2010.
In addition, GAO interviewed employers on why they added, changed, or eliminated mental health and substance use coverage after the passage of the law.
In all, 96% of employers who responded to the survey said they offered mental health and substance use coverage in 2008 and still offered it in their most recent plan year (either 2010 or 2011).

Just 2% of respondents said they nixed the mental health and substance use coverage in order to cut down on the costs of providing insurance to employees.
Employers reported covering the same diagnoses in 2010 that they did in 2008. Most employers reported covering five broad diagnoses -- mental disorders due to a general medical condition, substance-related disorders, schizophrenia and other psychotic disorders, mood disorders, and anxiety disorders -- in both 2008 and in 2010.

The most common change employers reported in their mental health substance use benefits from 2008 to 2010 was enhancing those benefits by removing limitations, such as the number of office visits allowed. A number of experts interviewed for the GAO report said it was common for employers to remove treatment limitations and annual dollar limits after the passage of the law.

The report also found that beneficiaries in need of mental health services generally paid lower-out-of-pockets costs after the passage of the parity law.
Most employers surveyed by GAO said making changes required by the law wasn't difficult.

However, it wasn't clear whether the passage of the law has had a positive impact on improving access for those with mental illnesses and substance use issues.
The GAO reviewed 30 studies on the issue, and 17 of those found that coverage or enhanced coverage through the parity law had an effect on access to or use of mental health and substance use services, while 13 studies found there was little or no effect.

Five studies found that plans with comprehensive coverage were linked with greater use of mental health services. For instance, one large company reduced copayments and made an effort to destigmatize mental illness, which led to an 18% increase in the likelihood of enrollees initiating mental health treatment.

And studies are just as varied on whether the mental health parity law has so far improved mental health, the report noted.

Thursday, November 10, 2011

NAMI Report:"State Mental Health Cuts: The Continuing Crisis"

NAMI North Carolina
Press Release
November 10, 2011
NAMI Report:"State Mental Health Cuts: The Continuing Crisis"

Contact: Jennifer Rothman, 919.788.0801 / 800.451.9681,

NAMI Report Shows NC Avoided Deep Cuts to Mental Health Funding
NAMI North Carolina Calls on State Leaders & Congressional Delegation to Protect Mental Health from Further Spending Cuts, Including 'Super Committee' Deficit Reduction

RALEIGH, N.C. (Nov. 10, 2011) - The National Alliance on Mental Illness (NAMI) North Carolina today announced that North Carolina ranks 24th among all states in terms of mental health care budget cuts made between fiscal years 2009 and 2012, according to a national report issued today by NAMI. In light of this new report, NAMI North Carolina urges the General Assembly and members of Congress to continue protecting North Carolinians living with mental illness from additional spending cuts, which will only exacerbate challenges to the mental health system.

"North Carolina's mental health system is at a crossroads," said NAMI North Carolina Executive Director Deby Dihoff. "While state leaders in North Carolina have worked hard to minimize cuts to mental health, the budget battles are far from over. We know that any further cuts will endanger our state hospitals and our community mental health system, which have both undergone tremendous turmoil and upheaval in recent years. We need a time of stability for the managed care approach to take hold and strengthen our system."

"North Carolinians need to contact members of Congress and state legislators to ask that mental health care be strengthened in the upcoming budget and protected from any cuts aimed at deficit reduction," continued Dihoff. "North Carolina's mental health care system is already at a breaking point, and if the congressional 'Super Committee' recommends further Medicaid or Medicare cuts this month, additional pressures will come into play. We can't balance the budget by compromising health care for our state's most vulnerable citizens."

According to the new NAMI report, "State Mental Health Cuts: The Continuing Crisis," North Carolina cut $7.3 million from state mental health care between fiscal years 2009 and 2012-a decrease of 1.2 percent. While the state made serious cuts to mental health spending, $48.2 million between fiscal years 2011 and 2012, the numbers don't tell the whole story. $45 million of those cuts were directed to the Local Management Entities, which were directed to take these one-time cuts largely out of their fund balances. Leaders in North Carolina made an effort to ensure that these cuts did not, in large part, affect service delivery. But North Carolina would like to join the majority of states, which increased their funding to mental health in the period from 2011-2012.

According to the NAMI report, during this same four-year period between fiscal years 2009 and 2012, South Carolina had the highest cuts totaling 39.3 percent of its budget, while North Dakota actually increased its mental health care spending by 48.l percent. See the report for full state-by-state data.

The NAMI report also outlines Medicaid pressures that threaten mental health care nationwide. Following the June 2011 loss of "enhanced" federal Medicaid matching funds that were part of economic stimulus legislation, states have had to fill the shortfall. North Carolina experienced an estimated loss of $343 million in enhanced funding. North Carolina's Medicaid program is now facing a nearly $140 million shortfall.

"We need to protect state and federal Medicaid revenues budgeted for mental health because for every dollar the state puts in, we receive two dollars from the federal government," continued Dihoff. "A recent report by the North Carolina Budget and Tax Center noted that if federal matching dollars are lost, it will cost North Carolina more than 13,000 jobs, and $613 million in labor income. State Medicaid funding means better health care for those with disabilities and a better economy."

NAMI North Carolina has developed a Public Policy Agenda outlining mental health priorities to guide state and federal policymakers as they make budget recommendations and consider funding allocations for mental health. NAMI North Carolina supports priorities that promote sustainable stability for North Carolinians living with mental illness such as additional community hospital beds and housing. To read the NAMI North Carolina Public Policy Agenda, click HERE.

The National Alliance on Mental Illness (NAMI) North Carolina is a grassroots non-profit organization providing support, education and advocacy for people living with mental illnesses and their families and friends. We are governed by a Board of Directors elected by membership and are 501(c)(3) accredited. NAMI NC is a part of NAMI which has over 210,000 members in 1,200 affiliates across the country. For more information, please visit

Thompson: Infant mortality rate threatened

The Daily Reflector
Greenville, NC

In a rare breath of good news, the governor’s office announced last week that North Carolina’s infant mortality rate in 2010 was the lowest in the state’s history. Fewer families endured the indescribable pain of losing a young child, a significant accomplishment for a state with a very poor track record preventing infant deaths. Unfortunately, the budget passed by state legislators last summer will likely undermine progress, particularly for eastern North Carolina and African-American families.
In 1988, North Carolina had the worst infant mortality rate in the country. Prodded by the shame of such a distinction, Republican Gov. Jim Martin and the Democratic state Legislature teamed up to implement a variety of public health programs to improve health outcomes for pregnant women and young children.
North Carolina’s infant mortality rate is now much closer to the middle of the pack in relation to the other 49 states.
The news, however, is not all good. African-American infants are still more than twice as likely to die as white babies, and eastern North Carolina counties suffer from disproportionately high mortality rates. This disparity will likely be exacerbated by the recent decisions of state legislators, who cut not only specific infant mortality prevention programs, but also broader health services for women and children.
Of specific importance to Greenville is the East Carolina University High-Risk Clinic, which serves as a regional hub for the treatment and support of high-risk pregnancies. In 2011, the Legislature chose not to renew the grant for the clinic.The elimination of state funding has led to the closure of two outreach clinics, the loss of key staff including the head nurse, and the doubling of wait times for patients. Since the success of prenatal services depends on providing the right care, at the right time and at the right place, these reductions in capacity and services will have a detrimental impact on infant mortality in the eastern part of the state.
Furthermore, the decision to cut the ECU High-Risk Clinic was penny-wise and pound-foolish. Just one pre-term birth is more expensive than the entire state allocation for the clinic, which was $325,000, a relatively small amount in a $19.7 billion budget. The cost of these preventable pre-term births will largely be shifted to the state’s Medicaid program, which was cut more than $350 million.
The Legislature’s budget decisions become even more troubling when the problem of infant mortality is viewed with an appropriately broad lens. After all, the infant mortality rate is a broad indicator of women’s and children’s health across the state.
In addition to prior pre-term births, diabetes and pre-existing health conditions are some of the major factors that lead to a high infant mortality rate. That’s why deep cuts to our state’s Medicaid program and the elimination of the Health and Wellness Trust Fund will have such a substantial impact on the infant mortality rate, especially in eastern North Carolina where rates of diabetes and obesity are already high.
We can do better. Gov. Martin, a Republican, and the Democratic legislature of 1988 showed that the two political parties can come together and prioritize the health and safety of North Carolina’s children. With the legislature back in session this week and again after Thanksgiving, it’s a perfect time for North Carolina’s current crop of elected officials to follow their example, put children first and fully fund the ECU High-Risk Clinic.

Rob Thompson is executive director of the Covenant with North Carolina’s Children, a coalition advocating policy that benefits children and families in North Carolina.

Sunday, November 6, 2011

Mental health services start fresh

by Kellen Moore

Tuesday was a fresh start for mental health services in Watauga County, as Daymark Recovery Services opened its doors at the sites of the former New River Behavioral HealthCare.

And on day 1, Daymark CEO Billy West had one message for clients and the community: “Bear with us.”

Although hundreds of details large and small were still being finalized even as business started Tuesday, Daymark staff reported a fairly calm transition.

“I think we're able to handle a lot of complicated things very well,” said Murray Hawkinson, site director for Watauga County.

Watauga County commissioners agreed Tuesday morning to lease former New River office space in the Human Services Building on the Poplar Grove Connector Road to Daymark for $5 per square foot per year.

With 13,775 square feet of space being used, Daymark will pay $5,739 per month in rent as well as $5,643 per month in janitorial and operating expenses, County Manager Deron Geouque said.

The rent is far below the fair market value of $10 to $12, but the board agreed to the reduced rate to minimize any disruption of services. The lease runs through June 30, 2012, and will be renegotiated then.

The rate is higher than the $3 per square foot that other members of the New River Service Authority board agreed to offer last week.

Inside the leased space, a skeleton crew was already operating Tuesday.

About half of the newly hired Daymark employees are attending orientation sessions Tuesday and Wednesday, and the other half will attend Thursday and Friday, West said.

The organization is still working to hire more physicians, and West said he did not know the exact number of employees that were in place as of Tuesday but was certain it was enough to keep the offices functioning.

In addition to staffing and space considerations, Daymark has been working to ensure that information technology systems are in place.

Computer systems and data lines are also being installed this week in the offices, West said, and Daymark also has had to purchase a new server to handle the data.

In a perfect transition, those data lines would have been connected and tested a month before the service provider opened, but Daymark didn't have that luxury, West said.

Telephone crisis lines are also continuing to function, although they may still refer to “New River Behavioral Healthcare” in automated messages for a while, West said.

West said all crisis employees have been instructed to continue as they have been until Daymark can address the crisis lines and services.

In Watauga County, 911 dispatchers had been answering New River's crisis lines after hours and connecting callers to the New River staff member on call, but Sheriff Len Hagaman told commissioners Tuesday he would like that system to end.

Commissioners agreed that the sheriff's office should continue answering the lines for the time being and directed Geouque to work with Daymark to find a new agreement.

With so many technology needs, Smoky Mountain Center has agreed to reimburse Daymark up to $370,000 to assist with the technology startup process, Smoky Mountain CEO Brian Ingraham said last week.

Although Daymark is covering the rest of its own significant startup costs at this point, West said he had “no problems” with the amount Smoky Mountain Center has provided to the organization.


While Daymark will provide the bulk of mental health services in the community, Smoky Mountain Center has also selected two other service providers to handle court-referred juvenile services and case management for people with intellectual or developmental disabilities.

True Behavioral Healthcare, based in Gastonia, hired 11 or 12 former New River staff members to start work Tuesday providing intellectual/developmental disability services.

In Boone, those employees are currently in the same space with Daymark employees until office space is arranged, True Behavioral CEO Carla Balestra said.

When IDD programs are up and running, True Behavioral plans to serve about 200 to 250 clients with an array of services, Balestra said.

Youth Villages is a national organization formed in Memphis, Tenn., in 1986 that will provide services to youth offenders and their families referred through the court system.

Sonja Luecke, a spokeswoman for Youth Villages, said the organization plans to begin helping youth by next week and started meeting some juveniles last week to assess their needs. Youth Villages does not yet have office space in Boone, but Smoky Mountain Center and the court are lending office space right now to conduct assessments, she said.

West said he was shocked to learn that Smoky Mountain Center would not select Daymark for the juvenile referral services and disappointed, as those enhanced services typically bring in revenue unlike many other mental health programs.

“What I told my staff was simply this: Am I surprised? Yes. Is this going to be the last thing that happens? No,” West said, adding that he felt there was too much to do to worry long about losing that solid source of revenue.

Luecke said court-involved youth and families can decide whether to follow their therapists to Daymark or use Youth Villages.

With dozens of decisions being made quickly and revenue streams still unknown, West said he is focused on ensuring that Daymark will not meet the same fate as New River.

“At the end of the year, we will have a system that may not be what you had yesterday, but it will be a system that will be sustained, and you will get a professional service for the long haul,” West said.

Durham-Wake Merger Would Create NC's Largest MCO

November 4, 2011

Durham, NC - A proposed merger between the Local Management Entities (LMEs) of Durham County and Wake County would create the state's largest Managed Care Organization (MCO) for public behavioral health and disability services based on population.

The Durham Center was selected by the NC Department of Health and Human Services to operate as an MCO under Medicaid 1915 (b)/(c) waivers effective January 1, 2013, serving Durham, Cumberland and Johnston counties. A merged Durham-Wake LME serving a four-county region including Wake would encompass a population of almost 1,690,000 residents.
A proposed merger agreement has been created and if approved by both parties, the merger would become effective July 1, 2012. The merged LME would begin managed care operations six months later. Durham County Commissioners will discuss the proposal on Monday, November 7 at their 9:00am regular work session.

The merged LME would be comprised of leadership and staff of both organizations with Ellen Holliman, currently Area Director of The Durham Center, serving as CEO. It would also have a new name and branding. Offices would be centrally located with satellite offices in both counties.

LME and other county government leadership from Durham and Wake have been engaged in discussions over the past year about how the two organizations could work together in some capacity. Significant similarities make The Durham Center and the Wake County LME logical partners for merger, with benefits anticipated for citizens, consumers, providers and taxpayers.

These include shared organizational values and missions and proven historical commitments to system of care philosophies and the use of evidence-based practices. The geographical proximity and similar urban compositions of the two counties create potential for pooling resources to address common challenges that can cause behavioral health costs to explode. Leadership and staffs of the two organizations have significant familiarity and existing working relationships with each other. In addition, there is major overlap of provider agencies serving consumers of both counties who frequently cross county lines.

"We are excited about the prospect of teaming with our colleagues in Wake County to help ensure that our citizens as well as those from Cumberland and Johnston counties receive the innovative, high-quality, recovery-focused behavioral health and disability services that result in positive outcomes," said Holliman. "We believe that all of our constituencies will benefit from the strength and viability that will result from the combined expertise and resources of the Durham and Wake LMEs."

For more information, contact Doug Fuller, director of Communications for The Durham Center at 919 560-7206.

Déjà vu in the world of mental health- NC Policy Watch

More than a decade ago, North Carolina’s system for providing services to individuals with mental health needs, developmental disabilities and addictive disease was deeply troubled. Allegations of fraud, mismanagement and conflicted governance signaled poor accountability mechanisms.

In response, the General Assembly directed the state Auditor to investigate the situation. In April 2000, the Auditor issued a report identifying two overarching problems: over-reliance on state institutions and lack of accountability among the local area programs responsible for providing community-based services. The findings also documented North Carolina’s failure to comply with the Americans with Disabilities Act’s “integration mandate.”

The report triggered massive changes to state law designed to reform the service system. The changes included a planned reduction of the number of state hospital beds – closing Dorothea Dix Hospital in Raleigh and replacing the derelict facilities in Goldsboro, Morganton and Butner with new buildings. The semi-autonomous governmental “area programs” created to provide direct services were replaced with county-operated systems or “Local Management Entities” (LMEs), acting under long-term contracts with the State to manage services.

Now fast-forward to 2011 to experience a profound sense of déjà vu. The State still relies on institutional-based care, but now in so-called “adult care homes.” Meanwhile, it has failed to develop adequate community-based services. The system responsible for providing services is again in trouble. Allegations of fraud, mismanagement, and conflicted governance again signal poor accountability mechanisms. To make matters even worse, the latest round of systemic failures are compounded by the State’s severe revenue deficiencies.

Again, the General Assembly has intervened. This time, the legislature has passed a law that mandates the conversion of all “Local Management Entities” into “Managed Care Organizations.” Essentially, the state is demanding radical statewide transformation based on an unproven model used by one very small LME called Piedmont Behavioral Healthcare. The state Department of Health and Human Services is being required to standardize and replicate Piedmont’s practices and processes for providing services across the entire state. This is a bit like the tail wagging the dog.

Unfortunately, this change raises several red flags for other reasons as well. Most notably, Piedmont’s practices include a pattern of violations of individuals’ constitutional due process rights and a disregard of judicial and administrative authority. Indeed, the organization I lead, Disability Rights NC, has filed two federal lawsuits challenging the Piedmont model – one of which (KC v. Cansler) challenges the lack of due process as guaranteed by the 14th Amendment and other federal requirements.

There are other problems with this managed care model.

Under the new law, the same organization (the MCO) is responsible for making requests for services and for approving and/or denying those services. This creates an inherent conflict of interest because it pits the need to save money against the needs and bests interests of the consumer – a problem that Piedmont has already been guilty of in multiple instances.

Yet another controversy surrounds a requirement that the new MCOs contract with Piedmont to obtain its business practices and processes. Remarkably, the contract actually contains a “non-disclosure” clause that would, in effect, keep the processes and practices hidden from the public eye. This is a huge problem because MCOs are not private entities but quasi-public entities serving the public interest with public money. Moreover, they’re linked to county governments subject to the state public records laws.

While the state and Piedmont claim the secrecy provisions are necessary to protect “intellectual property,” as a practical matter, such provisions will allow Piedmont and other newly-created MCOs to operate without real public oversight. This is especially true in light of Piedmont’s expansive view that it can refuse almost every request for information – including those with respect to how resources allocations are made, the standards by which providers are evaluated, and many others. This, of course begs the question: If the Piedmont model works so well, then why the secrecy? Why the lack of due process? And without transparency, how can there be public accountability?

In short, it appears that, once again, state leaders have failed to learn from past mistakes and in so doing continue to fail vulnerable populations. Let’s hope that it doesn’t take another decade for them to correct this latest mistake.

Vicki Smith is the Executive Director of Disability Rights North Carolina.

Thursday, October 20, 2011

Report Finds Hunger Cost North Carolina More Than $5.4 Billion in 2010

Report Finds Hunger Cost North Carolina More Than $5.4 Billion in 2010

Raleigh, N.C. -- Hunger cost North Carolina more than $5.4 billion in lost productivity and reduced outcomes last year, according to a recent report from the Center for American Progress. These findings come on the heels of alarming Census data which show unemployment in North Carolina stalled above 10 percent for the second consecutive year and poverty is increasing across the state.

In 2010, 15.7 percent of North Carolina households -- nearly one in six -- went hungry or faced food insecurity at some point during the year. When considered in relation to the total population, the direct and indirect costs of hunger averaged $570 per North Carolina resident -- about $1,452 per household.

North Carolina was one of just 12 states in which the estimated cost of hunger has increased by more than $1 billion since the start of the recession.

"These estimates are a gripping reminder that the social and economic implications of family economic security are far-reaching," said Barb Bradley, President and CEO of Action for Children North Carolina, a statewide policy research and advocacy organization that tracks child well-being in North Carolina. "When families struggle to put food on the table, the effects ripple through the state economy, creating greater health costs, educational problems and reduced opportunities for our children."

Research shows that children are disproportionately impacted by the experience of food insecurity -- an effect which persists well into their adult years. Children who grow up in food insecure households are more likely to go without health care, have increased school absenteeism and face greater risk of early academic failure, including dropping out of school, than their food-secure peers. As those children age and transition into the workforce, they encounter diminished outcomes in the form of limited employability and lower lifetime earnings.

Nationally, hunger-induced losses in educational outcomes, earnings and health cost the country an estimated $167.5 billion last year, an increase of 33.5 percent since 2007.

The report notes that expansions to a key federal nutrition assistance program, the Supplemental Nutrition Assistance Program (SNAP-formerly food stamps), helped many families meet some of their household food needs. In North Carolina, one in five residents, more than 1.9 million people, received SNAP benefits in 2010. Forty percent of them were children under the age of 18. Bradley says in these tough economic times, SNAP plays a pivotal role in helping to preserve the fiscal health of our state economy.

"Every dollar of SNAP benefit generates $1.84 in economic activity," said Bradley. "This means federal efforts to support families in tough times are not just good for individuals, they are critical for the state, keeping hunger-associated costs down, children in school and our workforce ready to drive the new economy. "

Read Hunger in America: Suffering We All Pay For.

# # #

Action for Children North Carolina is a leading statewide, nonpartisan, nonprofit policy research and advocacy organization dedicated to ensuring that North Carolina children are healthy, safe, well-educated and have every opportunity for success.

Monday, October 17, 2011

Monday Numbers

** This post is reposted by NC Policy Watch...every Monday, they post a list of numbers. NASW-NC is sharing this on their behalf as it's important to note the number of people who are affected by cuts in NC.

Monday numbers
Posted on 10/17/2011 by Chris Fitzsimon

1.5 million—number of people in North Carolina who do not have health insurance coverage (Five Reasons Everyday North Carolinians Need Medicaid, Even If They Don’t Know It, N.C. Health Access Coalition, October 2011)

27—percentage of Medicaid enrollees who are from middle class households including nursing home residents, people with disabilities, and victims of catastrophic accidents (Ibid)

73,000—amount in dollars of average annual cost of nursing home care for seniors (Ibid)

43,754—amount in dollars of the median income for a North Carolina family of four (Ibid)

70—percentage of nursing home residents nationwide who eventually become Medicaid recipients to pay for nursing home care (Ibid)

237,000—number of seniors in North Carolina who received Medicaid in 2008 (Ibid)

282,000—number of people with disabilities in North Carolina who received Medicaid in 2008 (Ibid)

683,000—number of infants in children in North Carolina who received Medicaid in 2008 (Ibid)

60,000—number of women in North Carolina who received Medicaid care affecting their pregnancy in 2008 (Ibid)

65—percentage of maternity stays for women under age 25 provided by Medicaid nationwide (Ibid)

3—number of years since study found that total medical spending is much lower when coverage is provided by Medicaid or SCHIP than it is when coverage is provided by private insurance. (Public And Private Health Insurance: Stacking Up The Costs, Health Affairs, 27, no. 4, 2008)

763 million—amount in state dollars cut from Medicaid in 2011-2013 in budget approved by the General Assembly in June (BTC REPORTS: The 2011-2013 Final Budget – Neglecting a Balanced Approach, Budget Costs Jobs and Delays Economic Recovery, June 2011)

1.56 billion—amount in federal Medicaid matching dollars that will be lost in the next two years because of state Medicaid cuts in the 2011-2013 budget (Ibid)

2.289 billion—total amount of reduction of state and federal Medicaid spending in the next two years because of state Medicaid cuts in the 2011-2013 budget (Ibid)

13,355—number of jobs that will be lost in North Carolina because of loss of Medicaid spending in 2011-2013 due to state cuts and resulting loss of federal matching dollars (BTC BRIEF: Legislative Budget Would Cost North Carolina 30,000 Jobs, Billions in Economic Output,” NC Budget and Tax Center: June 2011)
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Friday, September 16, 2011

Defense of Marriage

This past week, legislators met for three long days as promised at the end of last mini session in July. This mini session was to address the Defense of Marriage bill. NASW-NC members participated in many activities organized by Equality, NC and was inspired to watch their advocacy efforts and hard fight! Sadly, with just enough votes in both the House and the Senate, the bill was passed and ratified. In May, voters will have the chance to decide on the amendment.

What was the bill about?
The bill would provide an amendment to our state Constitution that would define marriage between one man and one woman and this would be the only recognized legal union in the state of NC (which is already a law here). During the May primary, voters will have the chance to vote on this Constitutional Amendment. If voters decide to vote no, the amendment will not be made. If voters decide yes, this amendment will be made to our Constitution; further discriminating our citizens. From now until then, NASW-NC, with the help of the PACE and Legislative Committees will be working with other organization on a campaign to vote no on this amendment.

Why is NASW-NC getting involved with this issue?
Our Code of Ethics is very clear about discrimination. We wrote a position paper on this very issue. It can be found by clicking here. Social workers are bound to the Code of Ethics in our practice and advocate on issues based on what is stated in our Code.

What can you do to help?

- Join the PACE and/or Legislative Committees if you're a member. These groups will be working on campaign efforts and other documents social workers can use.
- Write an Op-Ed to your local newspaper. Share with them how specific our Code of Ethics are about this issue.
- Continue to communicate with your legislators about how this issue affects you, your family, your practice, etc. They need to know how their constituents feel. Click here to find out who represents you.
- Talk to other social workers at your school, your place of employment or other networks you're a part of to let them know about this issue and what our Code of Ethics states.

From NASW's Code of Ethics (2008):
Social workers should not practice, condone, facilitate, or
collaborate with any form of discrimination on the basis of race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion or mental or physical disability.

Social workers should act to prevent and eliminate domination of, exploitation of, and discrimination against person, group, or class on the basis of race, ethnicity, national origin, color, sex, sexual orientation, age, marital status, political belief, religion, or mental or physical disability.”

To view our Code of Ethics, click here.

To view National's information on Diversity and Equity, click here.

Friday, September 9, 2011

AP: NC Did Not Miss Deadline for Adult Care Home Changes

Here’s the alert that went out on the wire after the change was made:

NC officials now say no deadline for mentally ill

RALEIGH, N.C. (AP) — A spokeswoman for the state Department of Health and Human Services says she was mistaken when she said the state had missed a deadline for dealing with thousands of people with mental illness who live in adult care homes.
Renee McCoy had said federal Medicaid regulators had given the state until Sept. 1 to develop a plan. Medicaid notified the state earlier this year it was in violation because of how it pays for the care of people with mental illness.
McCoy said Wednesday that there was no deadline. Agency Secretary Lanier Cansler tells The Associated Press the federal government at one point wanted a plan "by September," but that timeframe has been relaxed.
Meanwhile, state officials say the number of facilities whose patients may have to leave has increased.

Here’s the rewrite of the full story:

Michael Biesecker
Staff Writer
Raleigh, N.C.
919.510.8937 office
919.741.9163 cell
919.783.9184 fax
Twitter: mbieseck

The AP, founded in 1846, has a global network of 240 bureaus, providing news in text, audio, video, graphics and photos to more than 15,000 news outlets with a daily reach of 1 billion people worldwide.

Wednesday, September 7, 2011

A Message on CAP-I/DD Waivers

The Division, in partnership with DMA and with the support of DDTI will be hosting five CAP-I/DD Informational Sessions for the purpose of communicating the changes in the CAP-I/DD Comprehensive and Supports Waivers that will be effective 11/1/11. The sites for the sessions were selected to accommodate as many interested individuals as possible in each region. We would appreciate your assistance in forwarding the session information to the DD Consortium membership, and all you feel would be interested in attending. There will be no charge for these events, and registration is now open. The registration links for the events are listed as follows:

Tuesday, Sept. 20, Greenville

Wednesday, Sept. 21, Wilmington

Monday, Sept. 26, Asheville

Tuesday, Sept. 27, Newton

Wednesday, Sept. 28, Sanford

We are encouraging all who are interested in attending to register as soon as possible so we can monitor the attendance numbers. Also, we are encouraging people to arrive one hour or so ahead of the event as we expect large numbers.

Tuesday, September 6, 2011

ValueOptions Update

On Thursday, September 1st, ValueOptions requested to attend the Professional Association Council (PAC). NASW-NC is apart of this Coalition, meeting monthly to represent licensed professionals across North Carolina. The request for ValueOptions to attend our meeting was to inform us about a spike in denials of authorization and ways they are working to address the issue.

There are several points they wanted our members to be aware of when submitting authorizations:
1) Most of the time, reductions for requests are due simply by not having clinical information provided on the request(this information is missing from the request). Information such as diagnosis and treatment changes need to be noted, clinical support for service definitions need clinical support, no provider number listed, etc.
2) Lack of knowledge about due process rules that changed in May of 2011. For more information on this, click here or here for due process and prior approval information.
3) New process for submitting requests: Electronic submission mentioned in the August 2011 Medicaid Bulletin- this is effective 0ct. 1st, 2011. Providers will need to sign up with the Provider Connect website to submit requests, see authorization letters, etc. Click here and see the Section 1 for more information on Provider Connect.

ValueOptions is committed to help the providers of NC work with Best Practice standards. For more information on Practice Guidelines, click here.

NASW-NC Members: If you have any questions about this information, please contact Kay Paksoy at the chapter office.

Tuesday, August 16, 2011

Help SAMHSA Define Recovery!

Help SAMHSA Define Recovery

Over the past year, SAMHSA—as part of its Recovery Support Strategic Initiative—has worked with the behavioral health field to develop a working definition of recovery that captures the essential, common experiences of those recovering from mental and substance use disorders, along with 10 guiding principles that support recovery.

Recovery From Mental and Substance Use Disorders: A process of change through which individuals work to improve their own health and well-being, live a self-directed life, and strive to achieve their full potential.

Guiding Principles of Recovery:

Recovery is person-driven.
Recovery occurs via many pathways.
Recovery is holistic.
Recovery is supported by peers and allies.
Recovery is supported through relationships and social networks.
Recovery is culturally based and influenced.
Recovery is supported by addressing trauma.
Recovery involves individual, family, and community strengths and responsibility.
Recovery is based on respect.
Recovery emerges from hope.

What do you think about the working definition and guiding principles of recovery from mental and substance use disorders?

Commenting is open for 2 weeks, beginning Friday, August 12, and ending at 12 midnight Eastern Time on Friday, August 26.

Read More About the Definition of Recovery and Provide Feedback

Thursday, August 4, 2011

Medicaid Public Hearing

Tomorrow, Friday August 5th at the McKimmon Center in Raleigh. For more information, click here.

Friday, July 22, 2011

Contact your Congressperson!

The implementation of electronic Health Information Technology (HIT), required by the Affordable Care Act by 2014, represents a major change to the way that most LCSWs conduct their practices today. The cost of HIT software is estimated to be $44,000 per provider (Office of the National Coordinator, 2010). For physicians and hospitals, this cost will be covered by $2.7 billion which was built into the HITECH Act of 2009.

LCSWs and other mental health clinicians were not included as eligible for these funds, though we are expected to comply with HITECH requirements to receive Medicare payments (and most likely payment from all insurers). S. 539, the Behavioral Health IT Act, will make these funds available to mental health clinicians as well.

This is federal regulations so make sure to contact your FEDERAL congresspersons (not NC Legislators). Let them know to include social workers in an incentives package! To find who represents you federally, click here.

Tuesday, July 19, 2011

Long Time Child Advocate Receives Order of the Long Leaf Pine Award

Tom Vitaglione Receives High Honor from Governor Perdue

Raleigh, NC - Tom Vitaglione, Senior Fellow for Health and Safety at Action for Children North Carolina and Co-Chair of the Child Fatality Task Force, was honored by Governor Beverly Perdue yesterday with the Order of the Long Leaf Pine.

"It has been said that John Chapman, or Johnny Appleseed as we know him, scattered seeds of kindness and love across America," said State Senator Bill Purcell, who presented the award to Vitaglione yesterday. "No one has scattered seeds of kindness and love better than the man we honor today, Tom Vitaglione."

For three decades, Vitaglione served in the N.C. Division of Public Health as chief of the Children & Youth section of the Division of Women's & Children's Health. In that capacity, Vitaglione supervised all health programs for the state's youth, including a wide range of prevention and specialized services. He was instrumental in promoting and bringing about the Children's Health Insurance Program (CHIP) and was a strong advocate for the Infant Homicide Prevention Act.

After his retirement from the Division of Public Health, Vitaglione co-chaired the Child Fatality Task Force, a legislative study commission working to reduce child deaths, and served as Senior Fellow in Health and Safety for Action for Children North Carolina for 11 years. Vitaglione plans to retire from Action for Children and the Task Force in August.

Vitaglione also serves as President of the Board of Directors of the Malawi Children's Village (MCV), a village-based support program for orphans and other vulnerable children in Mangochi, Malawi. MCV provides shelter, food, safety, health care and education to over 2,000 HIV/AIDS orphans living with members of their extended family in 37 villages. Vitaglione and wife Eve served as Peace Corps volunteers in Malawi from 1965 to 1967 and have been involved with MCV since the project's inception. They plan to spend more time in Malawi after Vitaglione's retirement in August.

The Order of the Long Leaf Pine is one of the highest honors the governor can bestow on a North Carolina citizen. Created in the mid 1960s, the award is given to residents in recognition of a proven record of service or some other special achievement. Past recipients include such famous Tar Heels as Maya Angelou, Billy Graham, Michael Jordan, Bob Timberlake and Rick Hendrick, along with longtime state employees, prominent business executives and noted politicians, athletes, musicians, actors and advocates.

Action for Children North Carolina is a leading statewide nonprofit organization based in Raleigh and is the 2008 winner of the N.C. Center for Nonprofits' Nonprofit Sector Stewardship Award. Since its founding in 1983, Action for Children has been the leading voice for North Carolina's children. Action for Children is the KIDS COUNT partner in North Carolina and the state affiliate of the national organization, Voices for America's Children.

For more information, visit

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Monday, July 18, 2011

Benefits in Health Insurance

A study, first of it's kind, shows the benefits in providing health insurance to the poor. Click here to read the story from The New York Times.

Tuesday, July 12, 2011

The case for title protection in Philly

We, at NASW-NC, believe social work is a degree and not a title just anyone can use. Here is a case example from Philadelphia.

Click here to view the article from Social Workers Speak.

Disability Rights North Carolina wants you to weigh in!

Disability Rights North Carolina is North Carolina's protection and advocacy system for people with disabilities living in North Carolina. We provide individual and systems advocacy, including legal representation, to people with disabilities when their rights are violated. We uphold the provisions of the Americans with Disabilities Act and other federal and state laws.

Each year, we establish Targets which guide the expenditure of Disability Rights NC's resources for the coming year. The Targets drive the work that we do. They influence which cases we take and to whom we will provide direct representation. In 2010, we received more than 2,100 calls for assistance but had the resources to provide direct advocacy for only 870 callers.

On June 17, 2011, the Board of Directors of Disability Rights NC tentatively approved its Targets for 2012. Those 2012 Targets are now out for public comment. The Board will carefully consider all public input we receive before finalizing our annual Targets.

Our 2012 Targets focus on the impact of the state budget cuts to services for people with disabilities. They also reflect the requirements of our federal funders.

Please let us know what you think about the proposed 2012 Targets by responding to this brief survey at:

If you need assistance in completing this survey, contact Janice Willmott at 919-856-2195.

Thursday, July 7, 2011

Tuesday, June 28, 2011

We want to hear from you!

How were you affected as a social worker in North Carolina by this year's legislative session- what was cut from your budget, what legislation affected your practice, what will you be doing differently now?

Let us know by emailing Kay Paksoy at!

Gov. Perdue vetos abortion bill

Gov. Perdue has vetoed her 11th bill this legislative session. Yesterday, Perdue vetoed the very controversial abortion bill- HB 854 A Woman's Right to Know Act. NASW-NC was opposed to this legislation because of the state's interference with doctor-patient relationships imposed in this bill. This bill also stated that patients would have to under go "counseling" that is, in fact, not actual therapeutic counseling. We support Governor Perdue's veto of this bill.

For more information about the veto, click here.

Friday, June 24, 2011

Gov. Perdue signs Corporal Punishment Bill into law

Yesterday, Gov. Perdue signed Senate Bill 498: Modify Law Re: Corporal Punishment into law. This bill is long supported by NASW-NC. As many as 17 counties still administer corporal punishment as discipline. Under this measure, parents can state in writing that they want to exempt their children from this practice and schools can not use corporal punishment on those children.

NASW-NC is opposed to the use of corporal punishment in schools. We commend the Governor for her signature on this bill!

Gov. Perdue signs gun bill into law

In the heat of legislators introducing legislation, we saw a lot of gun bills being introduced- including 3 called the Castle Doctrine. From the beginning, NASW-NC was opposed to these bills because of the already dangerous task of social workers making home visits and providing therapy in the homes of clients. These bills would give residents, motorists and workers more protection if shooting someone they perceived to be a threat.

Towards the end of session, all the gun bills were rolled into one- Amend Various Gun Laws.

Though we oppose of the Governor signing this bill into law, we are still proud of how the Governor is handling other legislation being presented to her.

For more information about the Governor's signature, click here.

Gov. Perdue vetos Photo ID bill

Yesterday, Governor Perdue vetoed the very controversial voter ID bill. This bill would have particularly impacted persons of color and the elderly. The Senate has enough votes to override the veto but the House fell 5 votes short.

We are in support of the Governor's veto of this legislation.

For more information about the bill, click here.

Thursday, June 23, 2011

Man planned crime to go to jail for health care

The following story is a sad one out of NC. However, it's not uncommon to our state or our nation. This is why we do the work we do as social workers- to try and reach out to help those in need. It's a hard job, under tight circumstances and we often take a lot of heat for the work we do. Keep pressing forward in helping our communities!

For a link to the article:

Tuesday, June 21, 2011

Equality NC announces Interim Executive Director- MSW

We are very excited to share the announcement of Equality NC's new Interim Executive Director, Alex Miller. Alex is a 2007 graduate of UNC Chapel Hill's School of Social Work. We are excited Alex is on board with Equality and look forward to working with him.

To see Equality NC's press release, click here.

Monday, June 13, 2011

Medicaid Fraud Document

NASW-NC is a member of the Professional Association Council; representing licensed professionals in NC. This year, we worked to develop a Medicaid Fraud document to assist providers. The documents contains examples of fraud and who to contact if you suspect this is happening.

To see the document, click here.

This post has been updated- let us know if the link to the document does not work. It is located on NASW-NC's home page. Thanks for bringing it to our attention!

Friday, June 10, 2011

What's been happening on Jones Street?

The past two weeks have been extremely busy at the legislative building. Last Saturday morning, the House approved the final budget after the Senate, sending the $19.7billion budget to the Governor's desk. The Governor has until Tuesday at midnight to sign the budget bill into law, veto or leave it on her desk. If she vetoes the bill, the House can override her veto because of the 5 democrats that sided with the Republicans on the budget bill. Because of this, the Governor can leave it on her desk and not sign it or veto it and legislators can maintain the budget they've worked through.

This past week, legislators have been scrambling to meet crossover. Any bills that have not passed at least one chamber, have died. Thursday was the deadline for legislators to get their bills passed and this was then rescheduled for no later than Sunday, June 12th. There are a few exceptions to crossover of bills that have been assigned to particular committees.

So what have we been seeing this week?
Legislators debated HB 854, Abortion- Women's Right to Know Act that requires 24 hours waiting period, mandatory 72-4 hours before the procedure ultrasound and receiving printed material and other information that is termed counseling in the bill.
HB 351 Restore Confidence in Government, this is the photo ID to vote bill that was on the Republican platform during elections. Voters would have to show one of 8 acceptable forms of ID to vote. The State Board of Elections can issue a voter ID to those without an ID. The bill also includes that if you do not have ID, you can vote a provisional ballot and show ID later.
HB 650, Amend Various Gun Laws, at the beginning of session, several gun bills were filed. All were placed in this new bill including the Castle Doctrine bill that we have gone after. This bill also reduces the level of crime from a felony to a misdemeanor.
HB 659, Capital Procedure/Severe Mental Disability, those with severe mental disability to be exempt from the death penalty when prosecuted.
HB 799, Licensure by Endorsement/Military/Spouses, we have been working on this bill with our licensure board. The bill allows for a temporary license to practice if an active military spouse. This is to aid in the time it takes to obtain licensure when moving frequently in the military. Licensure boards are given discretion when issuing these licenses to look at training and background of those applying.
SB 597, Behavioral Health Services for Military/Funds, we have been active with this bill as it is to ensure that the behavioral health needs of military members and their families are met.

While there are many other bills we are following and tracking, these are a few updates. Please let us know if there are others you are watching and concerned about!

Monday, June 6, 2011

Defunding the Solution- NC Drug Courts

Defunding the solution

06.04.11 - 10:19 am

It costs, at minimum, $23,575 to house an inmate in one of North Carolina's minimum-security prisons for one year. If that offender is diverted to drug treatment court, the combined costs of close probation supervision, court visits and regular drug testing are $1,256 per year.

But the General Assembly's attempt at a state budget eliminates funding for drug treatment courts.

If you didn't hear courthouse staff and county governments howling in outrage and consternation, you weren't listening hard enough.

"They're just looking for ways to put their budget together without raising revenue," said Rep. Paul Luebke. He cited cuts to another program, sentencing services, that saves $7 for every $1 in funding, and noted, "you're cutting short term but ensuring higher costs later."

If this is a naked effort to push costs off the state's balance sheet and onto smaller governments, it might be working. Mecklenburg County's Board of Commissioners has tentatively agreed to spend $623,000 to fund the drug treatment courts that the state plans to abandon.


Because, in addition to the $22,319 saved on each drug offender who goes to treatment instead of to jail, programs like Durham's abuse, neglect and dependency court help parents get healthy enough to care for their kids.

That benefits communities. Last year, 51 parents of 93 children completed one of the 11 family-oriented drug treatment courts in North Carolina and regained custody of their children.

A 1996 study from San Diego State Univeristy found that when parents are able to visit their children in foster homes, they are up to 10 times more likely to be reunified with their kids. That's not something parents can do from prison.

There are clear implications for taxpayers.

The state offers foster care support checks that range from $475 for young children to $634 per teenager. Those payments to foster families don't include the administrative costs for oversight, social workers, or scholarships for children who age out of the foster care system.

And that's just the money. While foster care is preferable to a dangerous home, a 2001 study for the Washington State Institute for Public Policy found that children in foster care "score 15 to 20 percentile points below non-foster youth on achievement tests [and] only 59 percent of foster youth enrolled in 11th grade complete high school by the end of grade 12."

In government, there is always a fear of unintended consequences that result in great damage or great expense.

But in the state's push to eliminate drug courts, the inevitable consequences are infuriating.

No wonder Mecklenburg is considering paying for its own drug courts. It may come to that same question in Durham.

The fact that state government is mismanaging income and sales taxes, forcing counties to fill gaps with property taxes, should not be an excuse to avoid discussing how to save these programs.

© 2011

Thursday, June 2, 2011

HHS Announces Proposed Changes to HIPAA Privacy Rule

A Notice of Proposed Rule making concerning the accounting of disclosures requirement under the Health Insurance Portability and Accountability (HIPAA) Act Privacy Rule, is available for public comment. The proposed rule would give people the right to get a report on who has electronically accessed their protected health information.

The U.S. Department of Health and Human Services' (HHS) Office for Civil Rights (OCR) is proposing changes to Privacy Rule, pursuant to the Health Information Technology for Economic and Clinical Health (HITECH) Act. HITECH is part of the American Recovery and Reinvestment Act of 2009.

"This proposed rule represents an important step in our continued efforts to promote accountability across the health care system, ensuring that providers properly safeguard private health information," said OCR Director Georgina Verdugo. "We need to protect peoples' rights so that they know how their health information has been used or disclosed."

People would obtain this information by requesting an access report, which would document the particular persons who electronically accessed and viewed their protected health information. Although covered entities are currently required by the HIPAA Security Rule to track access to electronic protected health information, they are not required to share this information with people.

People may now read the proposed rule here. Search for Proposed Rule through August 1, 2011.

People who believe a covered entity has violated their (or someone else's) health information privacy rights or committed another violation of the HIPAA Privacy or Security Rule, may file a complaint with OCR at Additional information about OCR's enforcement activities can be found at

Thursday, May 19, 2011

Documentary on Special Needs Children to Air on Friday

This Friday , May 20, at 9 pm on UNCTV. The Bill Friday Program, "NC People" will interview Susan Ellis, co- producer of the Vail, Seattle , and Los Angeles Film Festivals awards documentary " Certain Proof - A Question of Worth". It's the story of three families and their special needs children. It will be repeated on Sunday May 22 at 5:30 pm.The documentary was developed and supported by New Voices Foundation.

Wednesday, May 18, 2011

Medicaid Patients could lose coverage

Half of North Carolina Medicaid Patients could Lose Coverage under House Budget Plan:
Federal Funding for NC would Plummet Under Block Grant Scheme
Raleigh, NC -

Half of Medicaid patients in North Carolina could lose their coverage if the budget plan passed by the U.S. House of Representatives were made into law, according to a recent report by the Kaiser Commission on Medicaid and the Uninsured.

North Carolina would receive nearly 40 percent less federal Medicaid funding over the next 10 years. The $61 billion drop in funding would be the 11th highest percentage decrease in federal Medicaid funding in the nation.

The House-passed budget plan repeals the planned Medicaid expansion currently in law under the Affordable Care Act and makes Medicaid a block grant, limiting federal dollars to the states and preventing the Medicaid program from expanding to cover more people during recessions.

"Currently, children enrolled in Medicaid are guaranteed preventive care and necessary follow-up treatment and services," said Barb Bradley, President and CEO of Action for Children North Carolina, a statewide nonpartisan, nonprofit child advocacy organization. "These changes would eliminate these protections for children, as well as repealing the maintenance of effort (MOE) protections that currently prevent states from rolling back Medicaid eligibility for children, parents, the disabled and others. This would be devastating for children in our state."

The changes would also pertain to the Children's Health Insurance Program (CHIP), which insures children in low-income families. States could choose to cut back or even completely eliminate their CHIP programs.

Medicaid and Health Choice (North Carolina's CHIP program) currently insure over one million children in North Carolina - nearly half the child population of the state.

House-passed budget plan would mean big drop in Medicaid funding for NC

The Kaiser Commission report found that over the next ten years, North Carolina would receive 39 percent fewer federal dollars for Medicaid under the House-passed budget plan than under current law - the 11th highest percentage drop in the nation. North Carolina would lose $61.1 billion over 10 years. In the year 2021, North Carolina would receive only about half - 49 percent - of the federal spending on Medicaid as expected under current law.

Half of Medicaid enrollees could lose coverage

Medicaid enrollment in North Carolina would drop by 50 percent by 2021 under the House-passed budget plan, assuming current spending per enrollee and cuts spread evenly across all groups.

Hospitals, NC economy would suffer

North Carolina's hospitals would also lose out. By 2021, federal and state Medicaid payments to hospitals in North Carolina would have fallen by 44 percent. North Carolina hospitals would lose $2.7 billion in 2021 alone.

The decrease in federal Medicaid spending would be a blow to North Carolina's economy. An article in the North Carolina Medicaid Journal found that in 2003, Medicaid supported 182,000 jobs in North Carolina. Federal Medicaid spending has only grown since then. (North Carolina Medical Journal, "Economic Impacts of Medicaid in North Carolina," March/April 2008)

The House passed their budget on April 15. The U.S. Senate has not yet voted on a budget plan.

The Kaiser report is available online at:

Action for Children North Carolina is a leading statewide nonprofit organization based in Raleigh and is the 2008 winner of the N.C. Center for Nonprofits' Nonprofit Sector Stewardship Award. Since its founding in 1983, Action for Children has been the leading voice for North Carolina's children. Action for Children is the KIDS COUNT partner in North Carolina and the state affiliate of the national organization, Voices for America's Children.
For more information, visit

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Thursday, May 12, 2011

Coming Full Circle: The Recovery Continuum

The North Carolina Mental Health Association Collaborative and Charlotte AHEC will host the Annual North Carolina Mental Health Association Collaborative Conference on Wednesday, May 18, 2011 at Friendship Missionary Baptist Church - Conference Center located in Charlotte, North Carolina. The conference entitled, Coming Full Circle: The Recovery Continuum, is a state-wide conference with guest speaker Mariel Hemingway, in addition to other highly- qualified, well-known speakers. This conference will bring together mental health experts, including the medical and recovery mental health professionals, community members, consumers, and vendors to promote the educational experience of current and relevant mental health information.

1 - Provide education regarding reducing stigma related to mental illness and improving understanding about mental health recovery
2 - Provide education regarding the philosophy of the Body Mind Spirit Movement and how it relates to mental health wellness and recovery, how it may be incorporated into daily living, the obstacles and challenges one may experience while living toward a balanced life, and how to find encouragement and motivation to continue.
3 - Provide education regarding how to stay on course with treatment, how to spot early signs of relapse, how to make a plan to get clients and consumers through difficult periods, and how to develop a relapse prevention plan.
4 - Encourage all consumers, providers, and individuals to make public policy and advocacy priority one by developing the beginnings of a statewide plan.

*Conference Speakers*
*Mariel Hemingway (Celebrity Speaker!!!)
*Amy Showalter, The Showalter Group Inc., Cincinnati, OH
*Robert Livingston, Consumer Presenter, Mecklenburg’s Promise, Charlotte, NC
*Lee Stephan, M.A., L.C.S.W., Director of Services for Adults with serious Mental Illness for Community Health Network, Indianapolis, IN
*Steve Jordan, M.A., Director, NC Division of MH/SA/DD, Raleigh, NC

NC Senate moves to reduce spanking in schools

NC Senate moves to reduce spanking in schools

By EmeryP.Dalesio
The Associated Press

RALEIGH, N.C. - The state Senate moved Tuesday to limit corporal punishment in public schools, approving legislation that would allow parents to save their misbehaving students from a paddling by telling school administrators to keep their hands off.

The 50-0 vote sends the measure to the House. The bill would ban corporal punishment for a student whose parent or guardian has stated that wish in writing at the start of the school year.

"It doesn't outlaw corporal punishment. It does make it a little more difficult to do," said Sens. Bill Purcell, D-Scotland. "Most research shows that hitting students won't modify long-term behavior."

North Carolina is one of 19 states that allow corporal punishment after New Mexico outlawed the practice last month, according to the Center for Effective Discipline, a Columbus, Ohio-based group that opposes the practice.

Even though North Carolina law allows paddling students, the choice is left to each of the state's 115 local school districts. Fewer than 20 rural districts in the state's southeast and west continue the practice.

Last year, the first for which school districts were required to report data on corporal punishment, there were 1,160 cases of the discipline measure statewide, led by Robeson County schools with 296 cases, the Department of Public Instruction said. That's up from 990 reported uses during the 2008-09 school year, led by 329 in Burke County.

Existing law requires paddling be administered away from view of other students, by a teacher or principal, under the observation of a witness.

A law passed last year allowed the parents of disabled students to opt-out if their local school district used corporal punishment, but the Senate measure would extend that option to all parents, said Tom Vitaglione of Action for Children North Carolina, a child advocacy group.

"Right now, a parent does not have the right to say that you can't hit my child," he said.

Wednesday, May 11, 2011

Transition Services Are Essential for Military Families

The Coalition Reports: Transition Services Are Essential for Military Families
Bookmark and Share Raleigh, NC - May 10, 2011 - The Coalition

The Coalition, a statewide group of 40 organizations and their members advocating in partnership to meet the needs of individuals managing disabilities, mental illness or the disease of addiction, asks the question: “What do returning Military Veterans, High School Seniors in June, and rising Kindergarteners all have in common?” In a word, transition. Add Traumatic Brain Injury, Cerebral Palsy, and Autism to the mix, and you have individuals with serious challenges in combination with a disruption of established routines and services.

In the case of Military families, a return from deployment may include the transition to civilian life with a Traumatic Brain Injury, or to the family at home severely stressed by the recent birth or diagnosis of a child with a developmental disability.

In some cases, both challenges may be present. Families faced with such challenges often experience chronic and sometimes acute levels of stress as they negotiate the service system and the new or deeply changed interpersonal relationships.

During times of transition, adequate services such as uninterrupted therapies, good basic and specialized medical care, and family support can make the difference between even the possibility of a healthy adjustment to a new life, or failure. Sometimes transition points require an increased need for services, without which the breakdown of the family, and even death, can occur.

NC has the fourth largest number of military personnel in the country, and is expected to receive 23,000 additional active duty members by the end of this year. There are currently 25,000 National Guard or Reserves living throughout the 100 NC counties without long-term access to military health insurance or on-base services. There is a steady arrival of returning veterans who have some wound, illness or injury. Finally, there has been an influx of military families from closed bases around the country who have elected NC as their home of choice because of its reputation for good hospitals and clinics serving people with disabilities. Like the general population, many of these families include individuals with some type of developmental disability.

There has been much attention of late to the behavioral health care needs of returning military veterans. Some excellent programs and services have become available and more will certainly be needed. While Traumatic Brain Injury is often clustered among the various behavioral health conditions experienced by some returning veteran, in NC it is considered a developmental disability, and it is present in larger proportion among service members than in the general population.

Federally funded services are not sufficient to meet the health care needs of the military population or the needs of military families managing developmental disability. Nonprofit programs, individual donors, and state funded services are going to become an increasingly important part of the solution. According to Colonel David Sutherland and Major John Copeland in their paper “Sea of Goodwill”, it is critical that a lifetime continuum of care be provided to our warriors, veterans, and families, to ensure that they thrive as contributing members of their communities…A successful transition and continued support will enhance not only veterans and their families, but also the community.”

The services and supports that help families affected by developmental disabilities including traumatic brain injury are more important than ever, as many returning military veterans and their families are part of a small but growing community who depend for their basic well-being upon the supports provided by state government services, among others.

For more information on this and other issues affecting those who manage disabilities, mental illness or the disease of addiction, visit The Coalition website at

Press Contact

Contact: Jane Phillips
Phone: 919-865-8724

Cutting Services to People with Disabilities

There’s a simple and harsh truth when it comes to serving people with disabilities: If you cut services that allow them to live in the most integrated setting, you will eventually force them into more institutionalized settings. This, in turn, will cost the state more money.
It is well documented that services in the community are cost-effective and, over time, save the state considerable dollars. According to a North Carolina Institute of Medicine Task Force, it costs on average 38 percent more each year in county, state and federal dollars to pay for someone to live in an institution like an adult care home than to pay for someone to live in the community.
We need only look at neighboring states to see both the cost benefits of community services and the consequences to a state with an institutional bias. In Tennessee, the state’s mental health office created more than 9,000 housing options for persons with disabilities in the last ten years. In contrast, North Carolina with 30% more residents has developed a third fewer options. Instead, we rely on institutional settings rather than developing services and supports – including community-based housing. Not only is this bad policy, it’s against the law – which brings us to Georgia.
The Americans with Disabilities Act (ADA) was passed in 1990 and bans discrimination on the basis of disability. Nine years later in a case filed against the Georgia Department of Human Resources, the U.S. Supreme Court ruled in Olmstead v. L.C. that people who live in institutions like state hospitals and nursing and adult care homes have a civil right to receive their care at home if they could live on their own with services and support. Last fall, Georgia avoided going to back to court a second time, this time with the U.S. Department of Justice (DOJ), over the state’s failure to live up to the terms of the Olmstead decision. The state agreed to spend $77 million over the next two years to set up new programs to help people with mental illness and intellectual disabilities get services in more integrated settings.
So what is the difference between an institution – like a state hospital or an adult care home – and more integrated settings in the community? In an institution, schedules are determined by staffing needs. Residents typically eat meals at the same time every day. They have limited choice. Freedom of movement is restricted. Decisions are frequently made on the behalf of residents – what they eat, how much, etc. Residents don’t get to pick who they live with; roommates are assigned. Personal relationships are often restricted or controlled. There is little privacy. Rules by their very nature are developed for the majority and not the individual. Decisions are based on what is best for the most people and the ability of staff to manage the residents. Though obviously different, these setting bear some resemblance to incarceration.
In more integrated settings, schedules are driven by individual need and preference. Independent living skills are developed – individuals learn how to shop and cook and get to decide what to eat and when. If the individual doesn’t want to go out (or feel up to going out) on a particular day, then the trip can be re-scheduled. Decisions can be based on preferences. Individuals have more choice about who they live with and what goes on in their personal space. In short, individuals have more control over their own lives.
An integrated setting does not separate people from community life but includes them in it.
The ADA says that states must develop a system of care that doesn’t rely on institutions. Unfortunately, North Carolina has not complied with this requirement. Instead, it has relied and continues to rely on institutional settings like adult care homes and has failed to develop community housing options. This violates the ADA and that’s why the nonprofit I direct, Disability Rights NC, filed a complaint with the United States Department of Justice last July. In November, the Department notified North Carolina that it would investigate. We’re hoping that if the General Assembly hasn’t heard the message that community services save money, they’ll pay attention to what happened in Georgia.
Fortunately, it looks like Governor Perdue is paying attention. Her proposed 2012 budget would spare mental health services from severe cuts and include $75 million for the Mental Health Trust Fund. Of course, even if the General Assembly were to appropriate a similar amount (something that looks increasingly unlikely given the current bleak budget outlook) there is no guarantee that such funds would be used to develop support housing options or other direct services. Let’s hope that both Governor and the General Assembly can read the writing on the wall and do the right thing.
Vicki Smith is the Executive Director of Disability Rights North Carolina.

Monday, May 9, 2011

Medicaid Specific: NC House Budget

MEDICAID: Budget cuts would hurt economy and families

The NC House budget would cut more than a billion dollars from the Health & Human Services budget over the next two years, with more than $710 million of that coming from Medicaid. That’s a bad idea for several reasons.
First, deep reductions in Medicaid funding mean fewer services for people who need them. In fact, 1.5 million people get care through Medicaid, and two-thirds of recipients are children.
Second, these cuts would mean the loss of more than $2 billion in federal Medicaid funding, since the federal government matches state Medicaid expenditures 2 to 1.
Third, the budget calls for lower reimbursements for the medical professionals who provide them. So, money that would have gone from the federal government into the pockets of local providers—and from there into local economies that need those dollars to create jobs—will instead stay in Washington, DC.

Wednesday, May 4, 2011

Coalition Rally on MH/DD/SAS

Coalition Advocacy Day
The Coalition welcomes you to our ADVOCACY DAY & POPCORN RALLY on TUESDAY, MAY 10, 2011!


Address: 16 West Jones Street, Raleigh, NC 27601

Registration will open at 8 am on the back portico of the Legislative Building. Participants can get information on the day’s legislative committee meetings, the current budget proposal and begin visits with legislators.

* Advocacy Trainings will take place in the Legislative Building Auditorium (third floor). Beginning at 9 am short trainings will be held on ways to effectively communicate your message to Legislators. Volunteers will be in the auditorium with tips & techniques for making the most of your legislative visit.
* Popcorn will be available on the portico beginning at 11 AM!
(Please note that lunch will NOT be provided.)
* RALLY: 12 pm on Bicentennial Mall on Jones Street, across from the Legislative Building
* PARKING: Passengers in vehicles of any kind must be dropped off at the LEGISLATIVE BUILDING and park in other locations. Directions & parking information can be found on the General Assembly’s website at

The Coalition encourages you to participate in this event as we advocate for funding for mental health, developmental disability, and addictive disease services!

For more information e-mail Elizabeth Cloud at

Monday, May 2, 2011

Broughton Hospital construction will start soon

Morganton, NC --

Broughton Hospital will soon be home to work crews.

Construction on the new state mental hospital is nearly ready to begin.
Coal Chute Road will be closed starting on Monday as contractor Rodgers Builders starts assembling its home base for the project, according to Jon Berry, Broughton Hospital’s special project manager.

Rodgers Builders will begin accepting bids for demolition next week. Berry said a number of old residences on the Broughton campus must be cleareed to make way for the new building on a 60-acre tract within Broughton's 386-acre campus.
How many jobs the project will create isn’t yet known, according to Berry, because subcontracting has not yet begun. Rodgers Builders gives preference to local contractors, he noted.

Berry said the construction is a “wonderful opportunity” for the local economy.
Scott Darnell, president of Burke Development Inc., said in December that he believes the project could create between 300 and 350 jobs.

Work should start by early June. It will take until the end of 2013 to complete, said Mark Van Sciver, a spokesman for the state Department of Health and Human Services.
The current staff will move to the new facility when it’s finished. Sciver said it’s too early to say whether there will be additional jobs in the new, larger hospital.
The state is building the 382-bed, 430,000-square-foot hospital to replace the existing facility.

The price tag is $154.8 million including new equipment, Sciver said. The funds come from state bond issues, so the current budget debate will not impact the new hospital’s construction.

The state needs the new facility, Sciver stressed, because the current buildings are aging and inefficient. He said construction of the new Broughton Hospital is part of an ongoing state initiative to upgrade mental-health facilities. Three new state-run mental health facilities will replace four dated ones.

Broughton is the second-oldest state-run psychiatric hospital in North Carolina. Now a 278-bed facility, its history dates to 1883. Broughton Hospital serves the state’s 37 westernmost counties.

Thursday, April 28, 2011

Update of bills

Now that deadlines are finished in both the House and Senate, all bills have been filed. I wanted to update you on a few. I recognize that there are many filed that interest different people but in the effort to respec your time, I will keep the list as small as possible. If you ever have questions about any of these, do not hesitate to contact me!

H 659, Capital Procedure / Severe Mental Disability

This bill has always been supported by NASW-NC. The bill prohibits defendants to have a severe mental disability at the time they committed a crime from being sentenced to death. Defendants can attempt to prove their severe mental disability either before trial or during the sentencing phase. However, mental disability which manifested itself primarily by repeated criminal conduct or was caused by alcohol or other drugs is not enough by itself to prevent the death penalty.

S 547, NC Human Trafficking Commission
S 547 creates the eighteen-member NC Human Trafficking Commission within the Department of Administration. The Commission is tasked with researching trafficking in NC and using that research to inform law enforcement, social services, and the general public. Also, the Commission will suggest new policies, procedures, or legislation. The Commission will assist in regional responses and identify gaps in law enforcement or social services and help identify responses to those gaps. NASW-NC is very supportive of this bill as Human Trafficking is a rapidly growing issue in NC and social workers have and will begin to face clients with trauma from such exposure.
H 734, Require Photo ID / Food Stamps Program
Requires a photo ID to electronic benefits transaction (EBT) cards used by SNAP food stamps) recipients. The bill provides for one additional individual to use the card on behalf of a primary recipient.

H 777, Defense of Marriage
Proposes a constitutional amendment to be placed on the ballot in 2012 with the text, “Marriage is a union of one man and one woman at one time. No other relationship shall be recognized as a valid marriage by the State.”

S 597/H 863: Behavioral Health Services for Military Funds.
NASW-NC is VERY supportive of this bill. This bill ensures that the behavioral health needs of members of the military, veterans, and their families are met. NC is unique to the number of military bases in the state and the problem of meeting the needs military families continues to grow. Social workers are on the forefront of these issues and are supported in this bill.

SB 607: Conform Medical Records Laws
As we are moving into more electronic health records, this bill ensures that those with mental illness are able to opt out of how their records are shared. NASW-NC has worked within the Coalition for Persons Disabled by Mental Illness to work on the language of this bill with Senator Stein.

Wednesday, April 27, 2011

Budget Action Alert


After nine hours of over 100 amendments to House Bill 200: Appropriations Act of 2011; the House will take this bill to the floor on Tuesday, May 3rd. Therefore, we have a small amount of time to address our issues. Below are some highlights that affect social work. PLEASE contact your legislatures and other members of the House to let them know how you will be impacted both professionally and personally.

Instructional Support staff cut by 4%: this means cuts to school social work positions.

Health and Wellness Trust Fund Eliminated: eliminate the Health and Wellness Trust Fund (HWTF) along with the Tobacco Trust Fund. The HWTF funds a wide variety of programs to prevent tobacco usage, obesity, aging services and infant mortality. The money from the HWTF is now redirected to debt service, agricultural projects, and $50 million for the University Cancer Research Fund.

Cuts to the Department of Juvenile Justice/Department of Corrections: Programs that help ex-offenders successfully integrate back into society were cut entirely.

Non-profit salaries capped: H200 caps salaries for all non-profits receiving state funds using a sliding scale based on the amount of state funding. For instance, if an organization receives more than $10 million, the salary cap is $100k; if it receives less than $1 million, the cap is $60k.

Tuition waivers eliminated: H200 would eliminate a variety of tuition waivers for NC community colleges, including waivers for:
-patients in state alcohol and drug rehab facilities
-any juveniles committed to DJJDP
-prison inmates
-students in HHS development programs

Early Childhood programs restructured
Smart Start
-No more than 8% of totals costs for all partnerships for admin costs
-Caps salaries at $80k for statewide partnership and $60K for local partnerships
-13% total match requirement (10% cash; 3% in-kind)
-No state funds on marketing campaigns
More at Four – H200 fundamentally changes More at Four from a pre-k program for low-income families to a child care subsidy program
-More at Four no longer under the Department of Public Instruction
-20% carve out for non-low income kids – this carve out means that 20% of the families served by More at Four funds will NOT be from low-income families
-H200 would also implement a co-pay on a rate scale the same as child care subsidies

Planned Parenthood funding cut: eliminate state funding and state-administered federal funds for Planned Parenthood. Cuts to this program are political in nature because it means cuts to breast and cervical cancer screening, family planning, sexually transmitted disease treatment, etc. Some legislators believe that these services can be provided by the Health Departments when in fact, the health departments are already overburdened and have significant wait times.

To access the Money Report, click here.
To access the Special Provisions, click here.

It is DIRE that you contact your legislators and let them know how devastating these cuts are. Take a look at the Money Report and see how you will be affect. The Money Report is the full report for Health and Human Services, Education, Adult Services, Child Services, Mental Health, etc.

If you need help contemplating what it all means and how to frame your message specific to you, please contact Kay Paksoy at the chapter office! Remember, this will be voted on on Tuesday!