Smoky Mt News
Training cops to handle mental health patients
By Julia Merchant • Staff Writer
It had been a long day for Adam Meyer.
The young man who has battled mental health issues for most of his life had entered another period of crisis, and had been waiting more than 48 hours for a bed to open up at one of the state's mental health hospitals.
It had been a long day for the person accompanying Meyer as well. In almost all cases, a sheriff or a transport person hired by the sheriff's department must wait with a patient until they're admitted to a state hospital — sometimes for days.
What happened next is disputable. But Meyers' mother, Patricia Frisbee Meyer, alleges when her son reached up from his bed at Haywood Regional Medical Center to speak with his social worker, the transport worker misinterpreted his actions and choked him in a forceful restraint.
Haywood County Sheriff Tom Alexander says the department investigated Meyers' complaint and that appropriate action was taken. While he can't speak further on the matter, he would say that the long waiting times are hard on everyone involved.
"A lot of these people get upset when they're sitting for hours. They get agitated, and I don't blame them," he says. "It's not an excuse, but that's the fact of the situation."
Too little funding
Chalk it up to a misunderstanding or a broken system, but the bottom line is that what happened to Adam Meyer might have been prevented.
That's the mantra being used by advocates of the Crisis Intervention Team program, which aims to train law enforcement officers how to better deal with individuals suffering from mental health issues.
Supporters of the program say it's an invaluable tool to prevent misunderstandings and mistreatment of mental health patients. They're not claiming it will fix the system completely, but that it will make officers' jobs easier.
Through the CIT program, a local chapter of the National Alliance on Mental Illness or another agency pairs with sheriffs departments and mental health service providers to form a task force that studies current policies and procedures in place for handling mental patients. A 40-hour training session on a wide range of topics is then offered to law enforcement.
The state of North Carolina was so taken with the program that it set aside $2,000 to give to each local management entity (LME) — the organization in charge of overseeing a region's mental health system. In a 15-county LME like Smoky Mountain Center for Mental Health, which represents the western region, that breaks down to about $130 a county.
"The issue is, what can you do meaningful with $2,000? " says Tom McDevitt, area director for the Smoky Mountain Center.
McDevitt says his agency and others suggested that the state set aside the money that would be given to each LME and pool it together to create a training program.
"They should have kept their $50,000 and put on a series of three to four regionally sponsored CIT training sessions," McDevitt says.
But he says the state ignored that idea and instead doled the money out individually. As a result, LME's are limited on how much they can help law enforcement gain access to the training.
"The funding is not enough to implement the program," acknowledges Molly Richardson, director of emergency services for the Balsam Center.
As a result, Smoky Mountain has had to get creative.
"Our plan is to basically use that very small amount of money to at least try and have educational events for law enforcement in our area to at least learn what it's about," McDevitt says. "That's as far as we can go with that little bit of money."
Limited resources
Sheriffs departments appear to support the CIT concept.
"I think it will make the process more smooth," says Macon County sheriff Robbie Holland. "It will give those first on the scene additional training, and I fully support that."
Swain County Sheriff Curtis Cochran agrees that the training could better equip officers to handle encounters with mentally ill individuals.
"I'm sure that we would change our approach a lot of times if we knew exactly what we were dealing with. On commitments, all we know is what we're told," he says. "That's very limited information."
Debra Dihoff, executive director of NAMI North Carolina, says that "often, when symptoms become out of control, police don't know to recognize symptoms of mental illness."
Data compiled by the Memphis Police Department — the first in the nation to implement the program — showed that before training, 20 percent of encounters with mentally ill people resulted in arrest. After training, that dropped to 1 percent, according to Dihoff.
But as helpful as the CIT program may be, law enforcement budgets are already stretched — and they may not be able to justify training that isn't mandatory. They may also not be able to afford to spare manpower in already understaffed departments.
"The main reason we haven't done it is a lack of manpower, because we're a small agency. Whenever you say you have four people that want to take off to go to this training, those four people have to be replaced by four other people," Holland says.
That's easier for bigger agencies with 300 or more employees, like Wake or Pitt counties, says Alexander. But it's harder for rural agencies in WNC, which employ a much smaller number of deputies.
"I believe in training, but then sometimes, you have to weigh out the cost. The manpower and the ability to be able to get it — you can't stay in school all the time, because work goes on," Alexander says.
To make CIT training more accessible to law enforcement agencies, Alexander suggests getting it accredited through the state Sheriff's Standard and Training Commission. That way, it could become part of the mandatory curriculum.
Forming a partnership with a local community college could also help. Agencies often do this to complete other training. The community college receives a certain sum for attracting a certain class size. In exchange, the college might provide things like refreshments, a luncheon and class pins. The LME also steps in and provides curriculum notebooks.
In one case, the state NAMI organization offered to reimburse the gas costs accrued by law enforcement agencies in five rural counties that traveled to a regional CIT training.
All in all, a partnership between all interested parties could be the most effective way to ensure officers receive the training they need to deal with mentally ill individuals.
Can it be implemented?
But the Smoky Mountain Center says so far, forming a partnership has been challenging. Besides Holland, it doesn't appear than any other law enforcement agency west of Buncombe County has made CIT training a budget priority.
"We've already made overtures to try and give reimbursement for pay and registration to send law enforcement staff, particularly sheriffs," says McDevitt. "We had little to no interest in anybody wanting to go anywhere."
McDevitt says that besides crunches in budgets and staffing, departments worry that they won't have the funding or infrastructure to keep CIT in place. And what's the point in training if it doesn't effectively take root?
"They say, we'll get exposed to this, and not be able to do anything to put CIT place. Where's the infrastructure? We don't have this, we don't have that," he says. "My approach is yeah, that's a given, but we can do these two or three things that would be an improvement."
Like so many other aspects of North Carolina's mental health system, it seems that CIT training is another instance where the state is promoting something without setting up the appropriate infrastructure or funding to carry it out.
And the problems law enforcement has with the mental health system won't be fixed with CIT training alone. Long waiting times, for example, will only be helped by adding more state hospital beds, and teaching officers how to deal with mental patients in the short term won't address the lapse in long term care due to a shortage of psychiatrists.
"We can train our people how to pick them up and deliver them to wherever, but all the training you give these officers in the world — unless you train them to be psychologists or something — is not going to solve the problem," says Alexander. "That's what the mental health field needs to understand. Don't blame it on the deputies and police officers. We do the best we can."
Wednesday, June 25, 2008
Tuesday, June 24, 2008
Time Sensitive Announcement from DHHS regarding incident to billing model
Time Sensitive Announcement from the Department of Health and Human Services
The Department of Health and Human Services (DHHS) has heard the concerns expressed regarding the change in billing for provisionally licensed clinicians announced on June 2, 2008 in Implementation Update # 44.
In order to address the concerns, DHHS is announcing today a change in that policy. The Department will implement the changes to the Medicaid "incident to" policy outlined in Implementation # 44; however, DHHS is removing the prohibition against Local Management Entities (LMEs) continuing to bill on behalf of agencies employing or contracting with provisionally licensed clinicians.
Effective July 1, 2008, the services of provisionally licensed clinicians may be billed to Medicaid and Division of Mental Health, Developmental Disabilities, and Substance Abuse Services funds in three ways: 1) when those clinicians are engaged in providing enhanced services, such as Intensive In-Home, Substance Abuse Intensive Outpatient, Assertive Community Treatment Team, etc.; 2) when they provide outpatient therapy under the revised "incident to" policy and their services are billed under the supervising physician’s provider number; and 3) when they provide outpatient therapy and the services are billed through the LMEs using "H" billing codes.
http://www.ncdhhs.gov/mhddsas/announce/provisionallylicensed6-24-08memo.pdf
The Department of Health and Human Services (DHHS) has heard the concerns expressed regarding the change in billing for provisionally licensed clinicians announced on June 2, 2008 in Implementation Update # 44.
In order to address the concerns, DHHS is announcing today a change in that policy. The Department will implement the changes to the Medicaid "incident to" policy outlined in Implementation # 44; however, DHHS is removing the prohibition against Local Management Entities (LMEs) continuing to bill on behalf of agencies employing or contracting with provisionally licensed clinicians.
Effective July 1, 2008, the services of provisionally licensed clinicians may be billed to Medicaid and Division of Mental Health, Developmental Disabilities, and Substance Abuse Services funds in three ways: 1) when those clinicians are engaged in providing enhanced services, such as Intensive In-Home, Substance Abuse Intensive Outpatient, Assertive Community Treatment Team, etc.; 2) when they provide outpatient therapy under the revised "incident to" policy and their services are billed under the supervising physician’s provider number; and 3) when they provide outpatient therapy and the services are billed through the LMEs using "H" billing codes.
http://www.ncdhhs.gov/mhddsas/announce/provisionallylicensed6-24-08memo.pdf
Monday, June 23, 2008
Legislative Update from our Friends at Action for Children
Greetings,
Action for Children NC is pleased to bring you this state and federal legislative update.
State:
Conferees Appointed and Conference Committees Started
Highlights of Senate Budget
Key Bills
Action Alerts
Federal:Medicaid Regulations: House Reaches Agreement with the White House
Senators Introduce JJDPA Reauthorization Bill
Conferees Appointed and Conference Committees Started
The NC Senate Appropriations Committee sent its budget to the Senate floor this week after hearing only six amendments, and the full Senate passed it on Thursday. The House did not concur with the budget, and both houses have appointed conferees. HHS conferees began meeting today (Friday) and will continue through the weekend and into Monday. Other committees will likely start on Monday. Advocates are getting the impression, though, that the controversial decisions like Health Choice funding are not likely to be decided in these public conference sessions, but instead by the big chairs closer to the middle of next week.
Please visit Action for Children’s website for a line-by-line comparison of the Governor’s, House and Senate budgets in the areas of Public Education, HHS, Justice and Public Safety, and
Housing.
Highlights of Senate budget
Action for Children Top Priority Items:
NC Health Choice: The Senate increased Health Choice by only $1.7M (compared to the House’s $10.4M) and mandated that enrollment be frozen in September. Enrollment can be unfrozen in April only if the federal government reauthorizes SCHIP and/or provides additional funding. Senator Hagan amended the bill to allow re-enrollment to begin as soon as more federal dollars are allocated to SCHIP (even if it’s prior to April 1), but still only 2.4 percent growth will be allowed this fiscal year (without the freeze, about 8 percent growth would be expected) and if the state does begin enrolling children again, the state share would have to come from existing resources within HHS.
A few key points:
A freeze in Health Choice is more harmful than you might think. Last time the program was frozen (in 2001), the rolls declined 18 percent over six months, and kept declining another 14 percent over four months even after the freeze was lifted. If that repeats itself, 36,000 children would be affected. A Sheps Center study (UNC Chapel Hill) found that the freeze caused financial hardship among affected families and children went without insurance, since parents could not afford premiums even when their employers offered insurance.
The Senate is trying to paint this as the federal government’s fault. It is true that SCHIP has not been reauthorized (though Congress tried twice and was vetoed by Bush), but every year Congress provides enough extra funds for “shortfall” states to cover their costs.
NC has been allocated enough federal money to keep Health Choice open until at least May 2009.
In order to stay open, however, the Senate needs to allocate the $10.4M state share to draw down the federal dollars.
Congress and health care advocates fully expect SCHIP to be reauthorized in March 2009 (or sooner) when a new administration is in place. (Congress—both liberals and conservatives—are 2-to-1 in favor of reauthorization and additional funding, and Governors across the ideological spectrum have been very vocal on the need to reauthorize and increase funding for SCHIP.) If for some reason Congress didn’t act in early 2009, the NC General Assembly is back in session in January and could begin acting then to freeze enrollment, as necessary.
All federal programs are reauthorized regularly, and the process is not usually used as an excuse for not allotting the necessary state dollars. No other state has issued a freeze warning on their SCHIP program. The Senate does not have to freeze Health Choice. Advocates will be working hard to move the HHS conference committee back toward the House proposal for children’s health insurance.
NC Kids Care: The Senate eliminated all the funding from NC Kids’ Care ($7M), citing federal obstacles to its implementation. They have pushed back the implementation date until July 1, 2009, which may not be legal and certainly is not workable. Advocates are working to get some funds back into the program this fiscal year, to get it up and running.
Child Care Subsidies: The Senate followed the House’s lead and allocated $9M in TANF funds for increased child care subsidies: enough to remove 1,100 children from the waiting list and prevent another 900 from losing their subsidies.
JCPC Funding: Like the House, the Senate reallocated recurring dollars to the Juvenile Crime Prevention Councils ($22.6M), but reduced the JCPC expansion funds from the House-proposed $1M to $200K. Advocates and JCPC service providers are working to move the JPS conference committee back to the House proposal.
Tax Package:
The Senate’s tax package was not included in the budget but considered separately. It includes an $18M tax break for the wealthy in the form of a repeal of the gift tax. It also includes a reduction on sales tax on propane fuel oil, which is used most often to heat lower-income homes. The Senate tax package does not increase the EITC percentage, and the budget does not include the House-recommended funds for EITC outreach. This will be a point of debate in conference committee.
Other Senate budget highlights include:
Public Education
More at Four: $41M in recurring funding (House: $23M nonrecurring);
Dropout grants: $8M (House: $15M);
Disadvantaged Student Supplemental Fund: $5M increase (House: $7M);
Per student funding for those with disabilities and the academically gifted: Increases similar to the House;
Child nutrition standards: $2M (House: $4M).
Learn and Earn: Increased funding for high schools equal to House, but cut online program more;
End of grade writing tests (4th, 7th, 10th grades): Eliminated, like the House.
Legislative Study Commission on public education funding formulas continued;
House programs not funded in Senate budget: Positive Behavior Support, Graduation Project, Transfer Center for 21st Century Skills, NC Science, Math and Technical Education Center, NC Humanities Council Teacher Institute Program.
HHS
Health Choice: $1.7M, which will force the program to freeze enrollment in September. Amendment passed on first reading to re-open enrollment upon receiving increased federal funding; growth cap of 2.4%. (House: $10.4M and increased growth cap.)
NC Kids’ Care: Eliminated for this fiscal year (House: delayed start until April 1, 2009);
Child care subsidies: $9M from TANF, same as House;
Foster care and adoption rate increases: Same percentage increase as House (30%), but appropriation is $140K lower;
Mental Health/DD/SA: $93M cut from community support programs (House: cut $86M), offset by a $36M one-time reserve for phase-in of community support reductions;
Medicaid: Freezes provider rates at 75% (House: freezes at 50.5%);
Health Net Grants: $2.8M (House: $3.8M);
Smart Start: $1M (House: $500K);
Child Welfare Collaborative: $900K, same as House (to fund more child welfare education in 4 universities);
Adolescent pregnancy prevention programs: $325K (House: $75K), plus a new $400K line-item. In addition, the Senate did not put the program on continuation review, like the House did. Over $1M has been cut in the last few years from these programs, even though teen pregnancy is the leading cause for girls dropping out of high school.
Juvenile Justice
JCPC funding restored: $22.7M, same as House;
JCPC expansion funding: $200K (House: $1M);
Additional positions in DJJDP: $726K, same as House (detention staff, nurse, psychologists);
Street Gang Prevention Act funding: $10M, same as House;
Support Our Students program: $200K cut, same as House.
JCPC-related studies included in House and Senate budgets:
Sentencing Commission: JCPC program effectiveness;
JCPC Funding Formula study: To propose a more current formula.
Housing
Home Protection Pilot Program: $3M, to expand statewide (House: $2M);
Housing Trust Fund: $2M, same as House;
Housing 400 Initiative for disabled persons: $7M, same as House.
Key Bills
Juvenile Justice:
HB 2492: Amend Release of Juvenile Escape Info was returned to the House Judiciary III committee and amended to include only adjudicated youth, not those simply alleged of committing a crime, lessening the negative impact of the bill somewhat. The bill then passed the full House.
SB 1358: Street Gang Prevention Act has passed the Senate and House.
Child Maltreatment:
HB 2339/SB 1860: Amend Child Abuse will be heard in House Judiciary I Committee on Tuesday.
HB 2338/SB 1733: Hospital Report Child Injuries will be heard next in House Judiciary II Committee.
Safety:
HB 2340: Transporting Children in the Open Bed of a Vehicle will be heard in House Judiciary I Committee on Tuesday.
HB 2487/SB 1891: Change Format of Drivers’ Licenses. Different versions of the bill have passed both houses. The House version will likely be taken up in the Senate.
HB 2341/SB 1736: Child Passenger Safety Technician Liability. Different versions of the bill have passed both houses. The House version will be taken up in Senate Judiciary I Committee.
SB 132: Protect Children from Sexual Predators Act expands scope of pornography laws, increases penalties for sexual exploitation of a minor, makes it illegal for registered sex offenders to access social networking sites online and forbids them to get name changes. The bill passed the Senate and House.
HB 2471/SB 1924: Require Carbon Monoxide Detectors. Passed House Insurance Committee and will go to House Judiciary II next.
Health:
HB 2254/SB 1669: Community Colleges/Tobacco Free. Passed Senate and first reading in the House and went to House Committee on Health.
HB 2253/SB 1686: Smoke-Free State and Local Bldg Grounds. Passed Senate.
Action Alerts
Health Choice
Please contact key Representatives and Senators who will be deciding which Health Choice proposal to go with over the next few days.
In the House: England, Insko, Alexander, Michaux and Earle
In the Senate: Basnight, Rand, Nesbitt and Dalton.
Message in the House: Stick to your original proposal. The Senate proposal does not make sense and is based on the falsehood that NC does not have enough federal funds to run the program this year.
Message in the Senate: Go with the House proposal. Mention the points outlined above:
A freeze is very harmful and has widespread negative repercussions, and
There is sufficient federal money now to fund the program almost to the end of next fiscal year, and everyone is expecting Congress to reauthorize and increase funding for this program before then (at least by March 2009). Many federal programs go through reauthorization processes: states don’t stop participating while that process is going on.
Earned Income Tax Credit (EITC) Percentage Increase(Alert from our friends at the NC Justice Center)
The House’s tax package includes an increase in the EITC percentage from 3.5 percent to five percent of the federal EITC. The Senate does not support this proposal, instead proposing a tax break for the wealthy: the elimination of the gift tax, which already applies only to gifts above $12,000 given to an individual person (spouses and nonprofits exempt).
Please contact your Representative and Senator to let them know you support tax credits for low-income working families, not tax breaks for the wealthy.
Juvenile Crime Prevention Councils Funding
The Senate and House have agreed to restore JCPC funding ($22.6M) but differ on the amount of expansion funding.
Please contact Senate and House leadership, as well as JPS Committee conferees in the House and Senate, to encourage them to fund the full $1M House-proposed expansion. These programs have not had an increase in almost a decade; as the state’s population grows, they are serving more children with the same amount of resources.
FEDERAL
Medicaid Regulations: House Reaches Agreement with the White House
House negotiators have reached an agreement with the White House on an emergency supplemental package that, if enacted, would provide a temporary 13-week extension of unemployment benefits for those who have exhausted their benefits and an extension of the moratoria on six of the seven Medicaid regulations (the one exception is the outpatient moratorium). The House approved the package, which now goes back to the Senate for action, likely next week.
Senators Introduce JJDPA Reauthorization Bill
Sens. Specter, Leahy and Kohl introduced legislation to reauthorize the Juvenile Justice and Delinquency Prevention Act, increasing funding for prevention, intervention and treatment programs to reduce the incidence of juvenile crime. The bill urges states to make key juvenile justice system improvements and establishes some guidelines, procedures and restrictions. It funds mental health and drug treatment programs for juvenile offenders and encourages states to address minority overrepresentation in the system. Improvement grants help states bring their systems into compliance with the Act.
Thank you,
Action for Children North Carolina
Action for Children NC is pleased to bring you this state and federal legislative update.
State:
Conferees Appointed and Conference Committees Started
Highlights of Senate Budget
Key Bills
Action Alerts
Federal:Medicaid Regulations: House Reaches Agreement with the White House
Senators Introduce JJDPA Reauthorization Bill
Conferees Appointed and Conference Committees Started
The NC Senate Appropriations Committee sent its budget to the Senate floor this week after hearing only six amendments, and the full Senate passed it on Thursday. The House did not concur with the budget, and both houses have appointed conferees. HHS conferees began meeting today (Friday) and will continue through the weekend and into Monday. Other committees will likely start on Monday. Advocates are getting the impression, though, that the controversial decisions like Health Choice funding are not likely to be decided in these public conference sessions, but instead by the big chairs closer to the middle of next week.
Please visit Action for Children’s website for a line-by-line comparison of the Governor’s, House and Senate budgets in the areas of Public Education, HHS, Justice and Public Safety, and
Housing.
Highlights of Senate budget
Action for Children Top Priority Items:
NC Health Choice: The Senate increased Health Choice by only $1.7M (compared to the House’s $10.4M) and mandated that enrollment be frozen in September. Enrollment can be unfrozen in April only if the federal government reauthorizes SCHIP and/or provides additional funding. Senator Hagan amended the bill to allow re-enrollment to begin as soon as more federal dollars are allocated to SCHIP (even if it’s prior to April 1), but still only 2.4 percent growth will be allowed this fiscal year (without the freeze, about 8 percent growth would be expected) and if the state does begin enrolling children again, the state share would have to come from existing resources within HHS.
A few key points:
A freeze in Health Choice is more harmful than you might think. Last time the program was frozen (in 2001), the rolls declined 18 percent over six months, and kept declining another 14 percent over four months even after the freeze was lifted. If that repeats itself, 36,000 children would be affected. A Sheps Center study (UNC Chapel Hill) found that the freeze caused financial hardship among affected families and children went without insurance, since parents could not afford premiums even when their employers offered insurance.
The Senate is trying to paint this as the federal government’s fault. It is true that SCHIP has not been reauthorized (though Congress tried twice and was vetoed by Bush), but every year Congress provides enough extra funds for “shortfall” states to cover their costs.
NC has been allocated enough federal money to keep Health Choice open until at least May 2009.
In order to stay open, however, the Senate needs to allocate the $10.4M state share to draw down the federal dollars.
Congress and health care advocates fully expect SCHIP to be reauthorized in March 2009 (or sooner) when a new administration is in place. (Congress—both liberals and conservatives—are 2-to-1 in favor of reauthorization and additional funding, and Governors across the ideological spectrum have been very vocal on the need to reauthorize and increase funding for SCHIP.) If for some reason Congress didn’t act in early 2009, the NC General Assembly is back in session in January and could begin acting then to freeze enrollment, as necessary.
All federal programs are reauthorized regularly, and the process is not usually used as an excuse for not allotting the necessary state dollars. No other state has issued a freeze warning on their SCHIP program. The Senate does not have to freeze Health Choice. Advocates will be working hard to move the HHS conference committee back toward the House proposal for children’s health insurance.
NC Kids Care: The Senate eliminated all the funding from NC Kids’ Care ($7M), citing federal obstacles to its implementation. They have pushed back the implementation date until July 1, 2009, which may not be legal and certainly is not workable. Advocates are working to get some funds back into the program this fiscal year, to get it up and running.
Child Care Subsidies: The Senate followed the House’s lead and allocated $9M in TANF funds for increased child care subsidies: enough to remove 1,100 children from the waiting list and prevent another 900 from losing their subsidies.
JCPC Funding: Like the House, the Senate reallocated recurring dollars to the Juvenile Crime Prevention Councils ($22.6M), but reduced the JCPC expansion funds from the House-proposed $1M to $200K. Advocates and JCPC service providers are working to move the JPS conference committee back to the House proposal.
Tax Package:
The Senate’s tax package was not included in the budget but considered separately. It includes an $18M tax break for the wealthy in the form of a repeal of the gift tax. It also includes a reduction on sales tax on propane fuel oil, which is used most often to heat lower-income homes. The Senate tax package does not increase the EITC percentage, and the budget does not include the House-recommended funds for EITC outreach. This will be a point of debate in conference committee.
Other Senate budget highlights include:
Public Education
More at Four: $41M in recurring funding (House: $23M nonrecurring);
Dropout grants: $8M (House: $15M);
Disadvantaged Student Supplemental Fund: $5M increase (House: $7M);
Per student funding for those with disabilities and the academically gifted: Increases similar to the House;
Child nutrition standards: $2M (House: $4M).
Learn and Earn: Increased funding for high schools equal to House, but cut online program more;
End of grade writing tests (4th, 7th, 10th grades): Eliminated, like the House.
Legislative Study Commission on public education funding formulas continued;
House programs not funded in Senate budget: Positive Behavior Support, Graduation Project, Transfer Center for 21st Century Skills, NC Science, Math and Technical Education Center, NC Humanities Council Teacher Institute Program.
HHS
Health Choice: $1.7M, which will force the program to freeze enrollment in September. Amendment passed on first reading to re-open enrollment upon receiving increased federal funding; growth cap of 2.4%. (House: $10.4M and increased growth cap.)
NC Kids’ Care: Eliminated for this fiscal year (House: delayed start until April 1, 2009);
Child care subsidies: $9M from TANF, same as House;
Foster care and adoption rate increases: Same percentage increase as House (30%), but appropriation is $140K lower;
Mental Health/DD/SA: $93M cut from community support programs (House: cut $86M), offset by a $36M one-time reserve for phase-in of community support reductions;
Medicaid: Freezes provider rates at 75% (House: freezes at 50.5%);
Health Net Grants: $2.8M (House: $3.8M);
Smart Start: $1M (House: $500K);
Child Welfare Collaborative: $900K, same as House (to fund more child welfare education in 4 universities);
Adolescent pregnancy prevention programs: $325K (House: $75K), plus a new $400K line-item. In addition, the Senate did not put the program on continuation review, like the House did. Over $1M has been cut in the last few years from these programs, even though teen pregnancy is the leading cause for girls dropping out of high school.
Juvenile Justice
JCPC funding restored: $22.7M, same as House;
JCPC expansion funding: $200K (House: $1M);
Additional positions in DJJDP: $726K, same as House (detention staff, nurse, psychologists);
Street Gang Prevention Act funding: $10M, same as House;
Support Our Students program: $200K cut, same as House.
JCPC-related studies included in House and Senate budgets:
Sentencing Commission: JCPC program effectiveness;
JCPC Funding Formula study: To propose a more current formula.
Housing
Home Protection Pilot Program: $3M, to expand statewide (House: $2M);
Housing Trust Fund: $2M, same as House;
Housing 400 Initiative for disabled persons: $7M, same as House.
Key Bills
Juvenile Justice:
HB 2492: Amend Release of Juvenile Escape Info was returned to the House Judiciary III committee and amended to include only adjudicated youth, not those simply alleged of committing a crime, lessening the negative impact of the bill somewhat. The bill then passed the full House.
SB 1358: Street Gang Prevention Act has passed the Senate and House.
Child Maltreatment:
HB 2339/SB 1860: Amend Child Abuse will be heard in House Judiciary I Committee on Tuesday.
HB 2338/SB 1733: Hospital Report Child Injuries will be heard next in House Judiciary II Committee.
Safety:
HB 2340: Transporting Children in the Open Bed of a Vehicle will be heard in House Judiciary I Committee on Tuesday.
HB 2487/SB 1891: Change Format of Drivers’ Licenses. Different versions of the bill have passed both houses. The House version will likely be taken up in the Senate.
HB 2341/SB 1736: Child Passenger Safety Technician Liability. Different versions of the bill have passed both houses. The House version will be taken up in Senate Judiciary I Committee.
SB 132: Protect Children from Sexual Predators Act expands scope of pornography laws, increases penalties for sexual exploitation of a minor, makes it illegal for registered sex offenders to access social networking sites online and forbids them to get name changes. The bill passed the Senate and House.
HB 2471/SB 1924: Require Carbon Monoxide Detectors. Passed House Insurance Committee and will go to House Judiciary II next.
Health:
HB 2254/SB 1669: Community Colleges/Tobacco Free. Passed Senate and first reading in the House and went to House Committee on Health.
HB 2253/SB 1686: Smoke-Free State and Local Bldg Grounds. Passed Senate.
Action Alerts
Health Choice
Please contact key Representatives and Senators who will be deciding which Health Choice proposal to go with over the next few days.
In the House: England, Insko, Alexander, Michaux and Earle
In the Senate: Basnight, Rand, Nesbitt and Dalton.
Message in the House: Stick to your original proposal. The Senate proposal does not make sense and is based on the falsehood that NC does not have enough federal funds to run the program this year.
Message in the Senate: Go with the House proposal. Mention the points outlined above:
A freeze is very harmful and has widespread negative repercussions, and
There is sufficient federal money now to fund the program almost to the end of next fiscal year, and everyone is expecting Congress to reauthorize and increase funding for this program before then (at least by March 2009). Many federal programs go through reauthorization processes: states don’t stop participating while that process is going on.
Earned Income Tax Credit (EITC) Percentage Increase(Alert from our friends at the NC Justice Center)
The House’s tax package includes an increase in the EITC percentage from 3.5 percent to five percent of the federal EITC. The Senate does not support this proposal, instead proposing a tax break for the wealthy: the elimination of the gift tax, which already applies only to gifts above $12,000 given to an individual person (spouses and nonprofits exempt).
Please contact your Representative and Senator to let them know you support tax credits for low-income working families, not tax breaks for the wealthy.
Juvenile Crime Prevention Councils Funding
The Senate and House have agreed to restore JCPC funding ($22.6M) but differ on the amount of expansion funding.
Please contact Senate and House leadership, as well as JPS Committee conferees in the House and Senate, to encourage them to fund the full $1M House-proposed expansion. These programs have not had an increase in almost a decade; as the state’s population grows, they are serving more children with the same amount of resources.
FEDERAL
Medicaid Regulations: House Reaches Agreement with the White House
House negotiators have reached an agreement with the White House on an emergency supplemental package that, if enacted, would provide a temporary 13-week extension of unemployment benefits for those who have exhausted their benefits and an extension of the moratoria on six of the seven Medicaid regulations (the one exception is the outpatient moratorium). The House approved the package, which now goes back to the Senate for action, likely next week.
Senators Introduce JJDPA Reauthorization Bill
Sens. Specter, Leahy and Kohl introduced legislation to reauthorize the Juvenile Justice and Delinquency Prevention Act, increasing funding for prevention, intervention and treatment programs to reduce the incidence of juvenile crime. The bill urges states to make key juvenile justice system improvements and establishes some guidelines, procedures and restrictions. It funds mental health and drug treatment programs for juvenile offenders and encourages states to address minority overrepresentation in the system. Improvement grants help states bring their systems into compliance with the Act.
Thank you,
Action for Children North Carolina
Action Alert: NC Against Domestic Violence
URGENT ACTION ALERT
The NC Senate has passed their version of the state budget and funding for domestic violence priorities is NOT INCLUDED.
The House budget does include funding for domestic violence programs and for House Bill 44.
We need you to act now to ensure that domestic violence is included in the final budget.
Members of the Senate and House are meeting in conference TODAY to work out a final budget.
We need your help to ensure that the priority items on NCCADV’s 2008 Legislative Agenda receive funding.
* * * * * *
Please contact the legislators listed at the end of this e-mail TODAY and ask them to include the following priorities in the final budget. The members especially need to hear from you if you live in their district.
You can click on the name to send an e-mail or call the switchboard in Raleigh at 919.733.4111 and ask to speak with the legislator. Please leave a message if you reach the legislative assistant.
1. Please include funding for local domestic violence programs.
v Approximately 90 domestic violence programs in the state provide crisis intervention services for all 100 counties, including shelter, crisis counseling, court advocacy and support groups.
v At least 501 women, children, and men have been murdered as a result of domestic violence in NC from January 1, 2002 – June 4, 2008, according to information collected by the North Carolina Coalition Against Domestic Violence.
v NC ranks 11th in the nation for the number of per capita homicides committed by men against women in our state in 2005, according to the Violence Policy Center.
v Local domestic violence programs responded to over 119,000 crisis line calls and served over 47,000 victims in person in FY 2006, including 5,550 children who received shelter services, according to the CFW/DVC.
v Over 1,100 victims were denied shelter at local domestic violence programs in FY 2006 because of a lack of capacity, according to the CFW/DVC.
2. Please include funds for House Bill 44.
Summary: HB 44 strengthens the enforcement of protective orders by reducing the number of prior convictions required from 3 to 1 to charge an offender with a Class H felony for violation of a protective order.
v Violation of a domestic violence protective order is a serious crime and is a red flag to the court system that the offender may commit a homicide.
v If we expect offenders to obey domestic violence protective orders, violations must be strictly enforced with meaningful consequences.
v An offender who violates a domestic violence protective order not only offends the victim, but also offends the court by violating the judge's order.
v 83 women, men, and children were murdered in NC because of domestic violence in 2007.
v HB 44 will save lives.
Senate Conferees
Sen. Linda Garrou, Co-Chair (Forsyth)
Sen. Charles W. Albertson, Co-Chair (Duplin, Lenoir, Sampson)
Sen. Charlie Smith Dannelly, Co-Chair (Mecklenburg)
Sen. Bob Atwater (Chatham, Durham, Lee)
Sen. Doug Berger (Franklin, Granville, Vance, Warren)
Sen. Stan Bingham (Davidson, Guilford)
Sen. Julia Boseman (New Hanover)
Sen. Daniel G. Clodfelter (Mecklenburg)
Sen. Janet Cowell (Wake)
Sen. Walter H. Dalton (Cleveland, Rutherford)
Sen. Katie G. Dorsett (Guilford)
Sen. Tony Foriest (Alamance, Caswell)
Sen. Steve Goss (Alexander, Ashe, Watauga, Wilkes)
Sen. Malcolm Graham (Mecklenburg)
Sen. Kay R. Hagan (Guilford)
Sen. Fletcher L. Hartsell, Jr. (Cabarrus, Iredell)
Sen. David W. Hoyle (Gaston)
Sen. Ed Jones (Bertie, Chowan, Gates, Halifax, Hertford, Northampton, Perquimans)
Sen. John H. Kerr III (Greene, Pitt, Wayne)
Sen. Eleanor Kinnaird (Orange, Person)
Sen. Vernon Malone (Wake)
Sen. Floyd B. McKissick, Jr. (Durham)
Sen. Martin L. Nesbitt, Jr. (Buncombe)
Sen. William R. Purcell (Anson, Richmond, Scotland, Stanly)
Sen. Joe Sam Queen (Avery, Haywood, Madison, McDowell, Mitchell, Yancey)
Sen. Tony Rand (Bladen, Cumberland)
Sen. Larry Shaw (Cumberland)
Sen. John Snow (Cherokee, Clay, Graham, Haywood, Jackson, Macon, Swain, Transylvania)
Sen. R. C. Soles, Jr. (Brunswick, Columbus, Pender)
Sen. Richard Stevens (Wake)
Sen. A. B. Swindell (Nash, Wilson)
Sen. David F. Weinstein (Hoke, Robeson)
House Conferees
Chairs:
Representative Michaux, Co-Chair (Durham)
Representative Adams, Co-Chair (Guilford)
Representative M. Alexander, Co-Chair (Mecklenburg)
Representative Crawford, Co-Chair (Granville, Vance)
Representative Haire, Co-Chair (Haywood, Jackson, Macon, Swain)
Representative Jeffus, Co-Chair (Guilford)
Representative Tolson, Co-Chair (Edgecombe, Wilson)
Representative Yongue, Co-Chair (Hoke, Robeson, Scotland)
Representative Holliman, Co-Chair (Davidson)
Representative Owens, Co-Chair (Camden, Currituck, Pasquotank, Tyrrell)
Representative McLawhorn (Pitt)
Subcommittee on Justice and Public Safety:
Representative Bordsen (Alamance)
Representative Love (Harnett, Lee)
Representative Goodwin (Montgomery, Richmond)
Representative Kiser (Lincoln)
Representative Mobley (Bertie, Gates, Hertford, Perquimans)
Representative Spear (Chowan, Dare, Hyde, Washington)
Representative Sutton (Robeson)
Representative R. Warren (Alexander, Catawba)
Representative Ray (Iredell)
Thank you for your help!
If you need assistance or have any questions, please contact Beth Froehling at bfroehling@nccadv.org or 1.888.232.9124.
The NC Senate has passed their version of the state budget and funding for domestic violence priorities is NOT INCLUDED.
The House budget does include funding for domestic violence programs and for House Bill 44.
We need you to act now to ensure that domestic violence is included in the final budget.
Members of the Senate and House are meeting in conference TODAY to work out a final budget.
We need your help to ensure that the priority items on NCCADV’s 2008 Legislative Agenda receive funding.
* * * * * *
Please contact the legislators listed at the end of this e-mail TODAY and ask them to include the following priorities in the final budget. The members especially need to hear from you if you live in their district.
You can click on the name to send an e-mail or call the switchboard in Raleigh at 919.733.4111 and ask to speak with the legislator. Please leave a message if you reach the legislative assistant.
1. Please include funding for local domestic violence programs.
v Approximately 90 domestic violence programs in the state provide crisis intervention services for all 100 counties, including shelter, crisis counseling, court advocacy and support groups.
v At least 501 women, children, and men have been murdered as a result of domestic violence in NC from January 1, 2002 – June 4, 2008, according to information collected by the North Carolina Coalition Against Domestic Violence.
v NC ranks 11th in the nation for the number of per capita homicides committed by men against women in our state in 2005, according to the Violence Policy Center.
v Local domestic violence programs responded to over 119,000 crisis line calls and served over 47,000 victims in person in FY 2006, including 5,550 children who received shelter services, according to the CFW/DVC.
v Over 1,100 victims were denied shelter at local domestic violence programs in FY 2006 because of a lack of capacity, according to the CFW/DVC.
2. Please include funds for House Bill 44.
Summary: HB 44 strengthens the enforcement of protective orders by reducing the number of prior convictions required from 3 to 1 to charge an offender with a Class H felony for violation of a protective order.
v Violation of a domestic violence protective order is a serious crime and is a red flag to the court system that the offender may commit a homicide.
v If we expect offenders to obey domestic violence protective orders, violations must be strictly enforced with meaningful consequences.
v An offender who violates a domestic violence protective order not only offends the victim, but also offends the court by violating the judge's order.
v 83 women, men, and children were murdered in NC because of domestic violence in 2007.
v HB 44 will save lives.
Senate Conferees
Sen. Linda Garrou, Co-Chair (Forsyth)
Sen. Charles W. Albertson, Co-Chair (Duplin, Lenoir, Sampson)
Sen. Charlie Smith Dannelly, Co-Chair (Mecklenburg)
Sen. Bob Atwater (Chatham, Durham, Lee)
Sen. Doug Berger (Franklin, Granville, Vance, Warren)
Sen. Stan Bingham (Davidson, Guilford)
Sen. Julia Boseman (New Hanover)
Sen. Daniel G. Clodfelter (Mecklenburg)
Sen. Janet Cowell (Wake)
Sen. Walter H. Dalton (Cleveland, Rutherford)
Sen. Katie G. Dorsett (Guilford)
Sen. Tony Foriest (Alamance, Caswell)
Sen. Steve Goss (Alexander, Ashe, Watauga, Wilkes)
Sen. Malcolm Graham (Mecklenburg)
Sen. Kay R. Hagan (Guilford)
Sen. Fletcher L. Hartsell, Jr. (Cabarrus, Iredell)
Sen. David W. Hoyle (Gaston)
Sen. Ed Jones (Bertie, Chowan, Gates, Halifax, Hertford, Northampton, Perquimans)
Sen. John H. Kerr III (Greene, Pitt, Wayne)
Sen. Eleanor Kinnaird (Orange, Person)
Sen. Vernon Malone (Wake)
Sen. Floyd B. McKissick, Jr. (Durham)
Sen. Martin L. Nesbitt, Jr. (Buncombe)
Sen. William R. Purcell (Anson, Richmond, Scotland, Stanly)
Sen. Joe Sam Queen (Avery, Haywood, Madison, McDowell, Mitchell, Yancey)
Sen. Tony Rand (Bladen, Cumberland)
Sen. Larry Shaw (Cumberland)
Sen. John Snow (Cherokee, Clay, Graham, Haywood, Jackson, Macon, Swain, Transylvania)
Sen. R. C. Soles, Jr. (Brunswick, Columbus, Pender)
Sen. Richard Stevens (Wake)
Sen. A. B. Swindell (Nash, Wilson)
Sen. David F. Weinstein (Hoke, Robeson)
House Conferees
Chairs:
Representative Michaux, Co-Chair (Durham)
Representative Adams, Co-Chair (Guilford)
Representative M. Alexander, Co-Chair (Mecklenburg)
Representative Crawford, Co-Chair (Granville, Vance)
Representative Haire, Co-Chair (Haywood, Jackson, Macon, Swain)
Representative Jeffus, Co-Chair (Guilford)
Representative Tolson, Co-Chair (Edgecombe, Wilson)
Representative Yongue, Co-Chair (Hoke, Robeson, Scotland)
Representative Holliman, Co-Chair (Davidson)
Representative Owens, Co-Chair (Camden, Currituck, Pasquotank, Tyrrell)
Representative McLawhorn (Pitt)
Subcommittee on Justice and Public Safety:
Representative Bordsen (Alamance)
Representative Love (Harnett, Lee)
Representative Goodwin (Montgomery, Richmond)
Representative Kiser (Lincoln)
Representative Mobley (Bertie, Gates, Hertford, Perquimans)
Representative Spear (Chowan, Dare, Hyde, Washington)
Representative Sutton (Robeson)
Representative R. Warren (Alexander, Catawba)
Representative Ray (Iredell)
Thank you for your help!
If you need assistance or have any questions, please contact Beth Froehling at bfroehling@nccadv.org or 1.888.232.9124.
NC Latino Resource Guide
The Latino Resource Guide produced by the Networks and Wake County Human Services is now online at the Wake County government website. I know many of you are not in Wake County, but state-wide and national resources are listed/included as well in this document.
To access, click on the link:
http://www.wakegov.com/NR/rdonlyres/A01B2ED6-E3A6-40CE-BACB-E35E961B6F44/0/latino_resource_guide.pdf
To access, click on the link:
http://www.wakegov.com/NR/rdonlyres/A01B2ED6-E3A6-40CE-BACB-E35E961B6F44/0/latino_resource_guide.pdf
Action Alert Adolescent Pregnancy Prevention Campaign
URGENT! LEGISLATIVE ACTION ALERT
ADOLESCENT PREGNANCY PREVENTION CAMPAIGN
OF NORTH CAROLINA
Monday, June 23, 2008
IF YOU VALUE THE PREGNANCY PREVENTION PROGRAMS AND INITIATIVES THAT NORTH CAROLINA HAS, THEN YOU NEED TO CONTACT BUDGET CONFEREES AND LEGISLATORS WHO REPRESENT YOU. IT IS EXTREMELY IMPORTANT THAT YOU START CONTACTING CONFEREES THIS MORNING. NOTE CONTACT INFORMATION AT THE BOTTOM OF THIS MESSAGE.
On Friday, June 20, after several hours of meetings by the conferees working to resolve differences in the Health and Human Services (HHS) section of the Senate and House's budget bills, the conferees reached agreement on a number of items. Unfortunately, no decisions were reached on funding for pregnancy prevention programs/initiatives. In fact, Rep. Verla Insko (D-Orange) asked that the items be "FLAGGED." "Flagged" means that the fate of these items will be determined later, and later could mean no funding. Since the conferees are millions of dollars over their spending target and will have to make cuts in order to balance the HHS budget, the funding for pregnancy prevention programs/initiatives seems bleak, and may not happen if you do not contact budget conferees. NOTE "flagged" items listed in the chart recorded below.
Some -- not all -- House members have expressed the following concerns: Questioned whether the programs are coordinated; Noted that there is lots of funding from various sources -- do not understand the funding scream; Want proof that programs are preventing pregnancies.
WHAT YOU CAN DO -- Contact conferees and share data and points that prove these programs have made and are continuing to make a tremendous difference in reducing teen pregnancy and out-of-wedlock births in NC. Results of the last outside evaluation of the Adolescent Parenting Program (APP) showed that participants were less likely to get pregnant the second time - one of the major goals of the program. Pregnant and parenting students not participating in the program were three times more likely than APP participants to get pregnant the second time. Participants in the APP were less likely to drop out of school. -- Another major goal of the program is to keep pregnant and parenting students in school. None participants in the APP program were three times more likely to drop out of school. (Funding for outside evaluation of the Adolescent Parenting Program and the Adolescent Pregnancy Prevention Program was cut about 8 years ago and was never restored.)
YOUR MESSAGE:
ASK BUDGET CONFEREES TO SUPPORT THE FUNDING FOR PREGNANCY PREVENTION PROGRAMS AND INITIATIVES THAT IS INCLUDED IN THE SENATE'S VERSION OF THE BUDGET. In North Carolina, funding for pregnancy prevention is low when compared to surrounding states. Legislators appropriate $1.79 million in state funds and the bulk of the remaining money going to combat teen pregnancy comes from federal block grant funds. As a result of legislative cuts made in 2001 and never restored, federal block grant funding is more than $ 1 million less than what was being appropriated in 2000 for pregnancy prevention and out-of-wedlock birth prevention.
ASK BUDGET CONFEREES TO INCLUDE ADDITIONAL FUNDING FOR SCHOOL-BASED AND SCHOOL-LINKED HEALTH CENTERS. (Conferees agreed to allow the $250,000 non-recurring funds that are included in the budget to be used for existing and new centers.)
NOTE: This chart does not contain prevention items that are "in agreement" in both budgets (Senate & House).
SENATE’S BUDGET
RATING
HOUSE’S BUDGET
RATING
Item #48 Teen Pregnancy Prevention Initiatives -- $400,000 recurring funds. This money, if approved, will save prevention programs in New Hanover, Anson, and Person Counties -- programs that are up for renewal of grant funds. In addition, other programs that have been approved for funding will be funded, and the overall program will be made whole.
DOUBLE PLUS
House’s budget does not contain this funding, which means prevention programs in New Hanover, Anson, and Person Counties -- programs that are up for renewal of grant funds -- will be cut. In addition, other programs that have been approved for funding will not be funded.
MINUS
Senate’s Budget does not contain this item.
DOUBLE PLUS
Current base state funding ($1.79 million) for all pregnancy prevention programs has been made non-recurring meaning that the base recurring funding has been made one-time money. (Item #49 in Money report)
MINUS
Item #48 Adolescent Pregnancy Prevention Program --- $325,000 Recurring -- This money is the grant-in-aid for the Adolescent Pregnancy Prevention Campaign (formerly Coalition) of NC.
MORE FAVORABLE
Item #45 Adolescent Pregnancy Prevention Program --- $75,000 Recurring -- This money is the grant-in-aid for the Adolescent Pregnancy Prevention Campaign (formerly Coalition) of NC.
FAVORABLE
CONCENTRATE ON HOUSE CONFEREES AND HOUSE LEADERS. MAKE YOUR CONTACTS UNTIL AGREEMENT IS REACHED ON THESE IMPORTANT BUDGET ITEMS. IF YOU DO NOT CONTACT THE BUDGET CONFEREES, THESE PROGRAMS WILL NOT BE FUNDED -- FUNDS WILL BE CUT.
Contact information for selected members of the Senate and House's budget conference committees are recorded below.
SENATE CONFEREES
HOUSE CONFEREES
Senator Bill Purcell (D) (Co-chairperson)
Room 625, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5953
H: (910) 276-7328 (Scotland, Richmond, Stanly, & Anson)
E-mail: Williamp@ncleg.net
Sen. Doug Berger (D) (Co-chairperson)
Room 622, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-8363
O: (919) 671-6565 (Franklin, Granville, Vance, & Warren)
E-mail: Dougb@ncleg.net
Sen. Steve Goss (D)
Room 1118 Legislative Building
Raleigh, NC 27601-2808
O: (919) 733-5742
H: (828) 265-2943 (Alexander, Ashe, Watauga & Wilkes)
E-mail: Steveg@ncleg.net
Sen. Martin Nesbitt (D)
Room 300-B Legislative Building
Raleigh, NC 27603-5925
O: (919) 715-3001
O: (828) 252-0490 (Buncombe)
E-mail: Martinn@ncleg.net
HOUSE CONFEREES CONTINUED
Rep. Jennifer Weiss (D)
Room 532, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3010
H: (919) 678-1367 (Wake)
E-mail: Jenniferw@ncleg.net
Rep. Beverly Earle (D) (Co-chairperson)
Room 634, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-2530
O: (704) 333-7180 (Mecklenburg)
E-mail: Beverlye@ncleg.net
Rep. Bob England (D) (Co-Chairperson)
Room 2219, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5749
O: (828) 245-7626 (Cleveland & Rutherford)
E-mail: Bobe@ncleg.net
Rep. Verla Insko (D) (Co-Chairperson)
Room 307 B1, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-7208
H: (919) 929-6115 (Orange)
E-mail: Verlai@ncleg.net
Rep. Jeff Barnhart (R) (Vice-chairman)
Room 608, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-2009
O: (704-786-2012 (Cabarrus)
E-mail: Jeffba@ncleg.net
Rep. William Brisson (D)
Room 1325, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5772
O: (910) 862-7007 (Bladen & Cumberland)
E-mail: Williambr@ncleg.net
Rep. Linda Coleman (D) (Vice-Chairperson)
Room 301 N, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5974
H: (919) 266-9037 (Wake)
E-mail: Lindac@ncleg.net
Rep. Charles Thomas (R)
Room 418C, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3012
O: (828) 681-5516 (Buncombe)
E-mail: Charlest@ncleg.net
HOUSE AND SENATE OVERALL BUDGET CONFEREES AND LEADERS
SENATE CONFEREES
HOUSE CONFEREES
Senator Linda Garrou (D) (Co-Chairperson)
Room 627, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5620
O: (336) 922-4192 (Forsyth)
E-mail: Lindag@ncleg.net
Senator Charlie Albertson (D) (Co-Chairperson)
Room 525, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5705
H: (910) 298-4923 (Duplin, Lenoir, & Sampson)
E-mail: Charliea@ncleg.net
Senator Charlie Dannelly (D) (Co-Chairperson)
Room 2010 Legislative Building
Raleigh, NC 27601-2808
O: (919) 733-5955
H: (704) 392-1227 (Mecklenburg)
E-mail: Charlied@ncleg.net
Sen. Walter Dalton (D)
Room 523, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3038
H: (828) 287-2908 (Cleveland & Rutherford)
E-mail: Walterd@ncleg.net
Senator Kay Hagan (D)
Room 411, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5856
O: (336) 379-8721 (Guilford)
E-mail: Kayh@ncleg.net
SENATE LEADERS
President Pro Tempore of Senate
Sen. Marc Basnight (D)
Room 2007, Legislative Building
Raleigh, NC 27601-1096
(Dare, Beaufort, Camden, Currituck, Hyde, Pasquotank, Tyrrell, & Washington)
919-733-6854 – Raleigh
E-mail: Marcb@ncleg.net
Senator Tony Rand (D) (Rules Chairman)
Room 300C, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-9892
O: (910) 222-8096 (Cumberland & Bladen)
E-mail: Tonyr@ncleg.net
Rep. Mickey Michaux (D) (Senior Chair)
Room 1227, Legislative Building
Raleigh, NC 27601-1096
O: (919) 715-2528
O: (919) 596-8181 (Durham)
E-mail: Mickeym@ncleg.net
Rep. Alma Adams (D) (Co-Chair)
Room 304, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5902
O: (336) 517-2312 (Guilford)
E-mail: Almaa@ncleg.net
Rep. Martha Alexander (D) (Co-Chair)
Room 2208, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5807
O: (704) 558-4670 (Mecklenburg)
E-mail: Marthaa@ncleg.net
Rep. Jim Crawford (D) (Co-Chair)
Room 2301, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5824
O: (252) 492-0185 (Granville & Vance)
E-mail: Jimcr@ncleg.net
Rep. Phil Haire (D) (Co-Chair)
Room 639, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3005
O: (828) 586-1771 (Jackson, Haywood, Macon & Swain)
E-mail: Philliph@ncleg.net
Rep. Joe Tolson (D) (Co-Chair)
Room 305, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3026
O: (252) 827-2749 (Edgecombe & Wilson)
E-mail: Joet@ncleg.net
Rep. Doug Yongue (D) (Co-Chair)
Room 1303, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5828
O: (910) 276-1727 (Hoke, Robeson & Scotland)
E-mail: Douglasy@ncleg.net
HOUSE LEADERS
Speaker Joe Hackney (D)
Room 2304, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-3451 (Orange, Chatham, Moore)
E-mail: Joeh@ncleg.net
Rep. Hugh Holliman (D)
Room 2301, Legislative Building
Raleigh, NC 27601-1096
O: (919) 715-0873
O: (336) 248-6272 (Davidson)
E-mail: Hughh@ncleg.net
Rep. Bill Owens (D) (Rules Chairman)
Room 635, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-0010
O: (252) 335-1850 (Camden, Currituck, Pasquotank, & Tyrrell)
E-mail: Billo@ncleg.net
Adolescent Pregnancy Prevention Campaign of North Carolina
3708 Mayfair Street, Suite 310
Durham, North Carolina 27707
Telephone: 919-226-1880 Fax: 919-226-1884
www.appcnc.org
If you wish to have your e-mail address removed from this distribution list, please contact Patricia Yancey pyancey@bellsouth.net or call the APPCNC office in Durham at 919-226-1880.
ADOLESCENT PREGNANCY PREVENTION CAMPAIGN
OF NORTH CAROLINA
Monday, June 23, 2008
IF YOU VALUE THE PREGNANCY PREVENTION PROGRAMS AND INITIATIVES THAT NORTH CAROLINA HAS, THEN YOU NEED TO CONTACT BUDGET CONFEREES AND LEGISLATORS WHO REPRESENT YOU. IT IS EXTREMELY IMPORTANT THAT YOU START CONTACTING CONFEREES THIS MORNING. NOTE CONTACT INFORMATION AT THE BOTTOM OF THIS MESSAGE.
On Friday, June 20, after several hours of meetings by the conferees working to resolve differences in the Health and Human Services (HHS) section of the Senate and House's budget bills, the conferees reached agreement on a number of items. Unfortunately, no decisions were reached on funding for pregnancy prevention programs/initiatives. In fact, Rep. Verla Insko (D-Orange) asked that the items be "FLAGGED." "Flagged" means that the fate of these items will be determined later, and later could mean no funding. Since the conferees are millions of dollars over their spending target and will have to make cuts in order to balance the HHS budget, the funding for pregnancy prevention programs/initiatives seems bleak, and may not happen if you do not contact budget conferees. NOTE "flagged" items listed in the chart recorded below.
Some -- not all -- House members have expressed the following concerns: Questioned whether the programs are coordinated; Noted that there is lots of funding from various sources -- do not understand the funding scream; Want proof that programs are preventing pregnancies.
WHAT YOU CAN DO -- Contact conferees and share data and points that prove these programs have made and are continuing to make a tremendous difference in reducing teen pregnancy and out-of-wedlock births in NC. Results of the last outside evaluation of the Adolescent Parenting Program (APP) showed that participants were less likely to get pregnant the second time - one of the major goals of the program. Pregnant and parenting students not participating in the program were three times more likely than APP participants to get pregnant the second time. Participants in the APP were less likely to drop out of school. -- Another major goal of the program is to keep pregnant and parenting students in school. None participants in the APP program were three times more likely to drop out of school. (Funding for outside evaluation of the Adolescent Parenting Program and the Adolescent Pregnancy Prevention Program was cut about 8 years ago and was never restored.)
YOUR MESSAGE:
ASK BUDGET CONFEREES TO SUPPORT THE FUNDING FOR PREGNANCY PREVENTION PROGRAMS AND INITIATIVES THAT IS INCLUDED IN THE SENATE'S VERSION OF THE BUDGET. In North Carolina, funding for pregnancy prevention is low when compared to surrounding states. Legislators appropriate $1.79 million in state funds and the bulk of the remaining money going to combat teen pregnancy comes from federal block grant funds. As a result of legislative cuts made in 2001 and never restored, federal block grant funding is more than $ 1 million less than what was being appropriated in 2000 for pregnancy prevention and out-of-wedlock birth prevention.
ASK BUDGET CONFEREES TO INCLUDE ADDITIONAL FUNDING FOR SCHOOL-BASED AND SCHOOL-LINKED HEALTH CENTERS. (Conferees agreed to allow the $250,000 non-recurring funds that are included in the budget to be used for existing and new centers.)
NOTE: This chart does not contain prevention items that are "in agreement" in both budgets (Senate & House).
SENATE’S BUDGET
RATING
HOUSE’S BUDGET
RATING
Item #48 Teen Pregnancy Prevention Initiatives -- $400,000 recurring funds. This money, if approved, will save prevention programs in New Hanover, Anson, and Person Counties -- programs that are up for renewal of grant funds. In addition, other programs that have been approved for funding will be funded, and the overall program will be made whole.
DOUBLE PLUS
House’s budget does not contain this funding, which means prevention programs in New Hanover, Anson, and Person Counties -- programs that are up for renewal of grant funds -- will be cut. In addition, other programs that have been approved for funding will not be funded.
MINUS
Senate’s Budget does not contain this item.
DOUBLE PLUS
Current base state funding ($1.79 million) for all pregnancy prevention programs has been made non-recurring meaning that the base recurring funding has been made one-time money. (Item #49 in Money report)
MINUS
Item #48 Adolescent Pregnancy Prevention Program --- $325,000 Recurring -- This money is the grant-in-aid for the Adolescent Pregnancy Prevention Campaign (formerly Coalition) of NC.
MORE FAVORABLE
Item #45 Adolescent Pregnancy Prevention Program --- $75,000 Recurring -- This money is the grant-in-aid for the Adolescent Pregnancy Prevention Campaign (formerly Coalition) of NC.
FAVORABLE
CONCENTRATE ON HOUSE CONFEREES AND HOUSE LEADERS. MAKE YOUR CONTACTS UNTIL AGREEMENT IS REACHED ON THESE IMPORTANT BUDGET ITEMS. IF YOU DO NOT CONTACT THE BUDGET CONFEREES, THESE PROGRAMS WILL NOT BE FUNDED -- FUNDS WILL BE CUT.
Contact information for selected members of the Senate and House's budget conference committees are recorded below.
SENATE CONFEREES
HOUSE CONFEREES
Senator Bill Purcell (D) (Co-chairperson)
Room 625, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5953
H: (910) 276-7328 (Scotland, Richmond, Stanly, & Anson)
E-mail: Williamp@ncleg.net
Sen. Doug Berger (D) (Co-chairperson)
Room 622, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-8363
O: (919) 671-6565 (Franklin, Granville, Vance, & Warren)
E-mail: Dougb@ncleg.net
Sen. Steve Goss (D)
Room 1118 Legislative Building
Raleigh, NC 27601-2808
O: (919) 733-5742
H: (828) 265-2943 (Alexander, Ashe, Watauga & Wilkes)
E-mail: Steveg@ncleg.net
Sen. Martin Nesbitt (D)
Room 300-B Legislative Building
Raleigh, NC 27603-5925
O: (919) 715-3001
O: (828) 252-0490 (Buncombe)
E-mail: Martinn@ncleg.net
HOUSE CONFEREES CONTINUED
Rep. Jennifer Weiss (D)
Room 532, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3010
H: (919) 678-1367 (Wake)
E-mail: Jenniferw@ncleg.net
Rep. Beverly Earle (D) (Co-chairperson)
Room 634, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-2530
O: (704) 333-7180 (Mecklenburg)
E-mail: Beverlye@ncleg.net
Rep. Bob England (D) (Co-Chairperson)
Room 2219, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5749
O: (828) 245-7626 (Cleveland & Rutherford)
E-mail: Bobe@ncleg.net
Rep. Verla Insko (D) (Co-Chairperson)
Room 307 B1, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-7208
H: (919) 929-6115 (Orange)
E-mail: Verlai@ncleg.net
Rep. Jeff Barnhart (R) (Vice-chairman)
Room 608, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-2009
O: (704-786-2012 (Cabarrus)
E-mail: Jeffba@ncleg.net
Rep. William Brisson (D)
Room 1325, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5772
O: (910) 862-7007 (Bladen & Cumberland)
E-mail: Williambr@ncleg.net
Rep. Linda Coleman (D) (Vice-Chairperson)
Room 301 N, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5974
H: (919) 266-9037 (Wake)
E-mail: Lindac@ncleg.net
Rep. Charles Thomas (R)
Room 418C, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3012
O: (828) 681-5516 (Buncombe)
E-mail: Charlest@ncleg.net
HOUSE AND SENATE OVERALL BUDGET CONFEREES AND LEADERS
SENATE CONFEREES
HOUSE CONFEREES
Senator Linda Garrou (D) (Co-Chairperson)
Room 627, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5620
O: (336) 922-4192 (Forsyth)
E-mail: Lindag@ncleg.net
Senator Charlie Albertson (D) (Co-Chairperson)
Room 525, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5705
H: (910) 298-4923 (Duplin, Lenoir, & Sampson)
E-mail: Charliea@ncleg.net
Senator Charlie Dannelly (D) (Co-Chairperson)
Room 2010 Legislative Building
Raleigh, NC 27601-2808
O: (919) 733-5955
H: (704) 392-1227 (Mecklenburg)
E-mail: Charlied@ncleg.net
Sen. Walter Dalton (D)
Room 523, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3038
H: (828) 287-2908 (Cleveland & Rutherford)
E-mail: Walterd@ncleg.net
Senator Kay Hagan (D)
Room 411, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5856
O: (336) 379-8721 (Guilford)
E-mail: Kayh@ncleg.net
SENATE LEADERS
President Pro Tempore of Senate
Sen. Marc Basnight (D)
Room 2007, Legislative Building
Raleigh, NC 27601-1096
(Dare, Beaufort, Camden, Currituck, Hyde, Pasquotank, Tyrrell, & Washington)
919-733-6854 – Raleigh
E-mail: Marcb@ncleg.net
Senator Tony Rand (D) (Rules Chairman)
Room 300C, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-9892
O: (910) 222-8096 (Cumberland & Bladen)
E-mail: Tonyr@ncleg.net
Rep. Mickey Michaux (D) (Senior Chair)
Room 1227, Legislative Building
Raleigh, NC 27601-1096
O: (919) 715-2528
O: (919) 596-8181 (Durham)
E-mail: Mickeym@ncleg.net
Rep. Alma Adams (D) (Co-Chair)
Room 304, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-5902
O: (336) 517-2312 (Guilford)
E-mail: Almaa@ncleg.net
Rep. Martha Alexander (D) (Co-Chair)
Room 2208, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5807
O: (704) 558-4670 (Mecklenburg)
E-mail: Marthaa@ncleg.net
Rep. Jim Crawford (D) (Co-Chair)
Room 2301, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5824
O: (252) 492-0185 (Granville & Vance)
E-mail: Jimcr@ncleg.net
Rep. Phil Haire (D) (Co-Chair)
Room 639, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3005
O: (828) 586-1771 (Jackson, Haywood, Macon & Swain)
E-mail: Philliph@ncleg.net
Rep. Joe Tolson (D) (Co-Chair)
Room 305, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 715-3026
O: (252) 827-2749 (Edgecombe & Wilson)
E-mail: Joet@ncleg.net
Rep. Doug Yongue (D) (Co-Chair)
Room 1303, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-5828
O: (910) 276-1727 (Hoke, Robeson & Scotland)
E-mail: Douglasy@ncleg.net
HOUSE LEADERS
Speaker Joe Hackney (D)
Room 2304, Legislative Building
Raleigh, NC 27601-1096
O: (919) 733-3451 (Orange, Chatham, Moore)
E-mail: Joeh@ncleg.net
Rep. Hugh Holliman (D)
Room 2301, Legislative Building
Raleigh, NC 27601-1096
O: (919) 715-0873
O: (336) 248-6272 (Davidson)
E-mail: Hughh@ncleg.net
Rep. Bill Owens (D) (Rules Chairman)
Room 635, Legislative Office Building
Raleigh, NC 27603-5925
O: (919) 733-0010
O: (252) 335-1850 (Camden, Currituck, Pasquotank, & Tyrrell)
E-mail: Billo@ncleg.net
Adolescent Pregnancy Prevention Campaign of North Carolina
3708 Mayfair Street, Suite 310
Durham, North Carolina 27707
Telephone: 919-226-1880 Fax: 919-226-1884
www.appcnc.org
If you wish to have your e-mail address removed from this distribution list, please contact Patricia Yancey pyancey@bellsouth.net or call the APPCNC office in Durham at 919-226-1880.
Smoky Mt News: MH Reform
Another bad mental health care decision
By Raymond Turpin • Guest Columnist
-Smoky Mt News
Provisionally licensed therapists are individuals who have completedtheir formal education and training, hold master's or doctoral degreesfrom accredited graduate programs, and lack only supervised hours ofpractical experience in order to qualify for their licensure exam. Foryears, they have been able to come to North Carolina and provide much-needed therapy services to Medicaid recipients while receiving adequatesupervision from licensed professionals in their respective fields.
They have helped offset ongoing, serious workforce shortages in thisstate, and their services are critical to providers statewide who aretrying to meet the mental health needs of their communities. Theiroutpatient therapy services continue to be vitally important to thesurvival of North Carolina's fragile mental health delivery system,which is still reeling after years of mismanagement by the verygovernment agencies entrusted with its care and development.
In a continuance of puzzling decisions, North Carolina's Division ofMedical Assistance has announced that beginning July 1, provisionallylicensed therapists will no longer be able to provide outpatienttherapy for Medicaid recipients unless they work for a physician,accept only mental health referrals from said physician, and deliverall services on-site where the physician practices medicine. Thephysician is responsible for supervising the therapy, but provisionallylicensed therapists must still seek supervision from approved licensedprofessionals in their field in order to accrue hours towardslicensure.
If a provisionally licensed therapist does not work directly under aphysician, they will only be allowed to provide Medicaid's "enhanced"services, which consist of the services such as Community Support thatthe state has mismanaged into a confusing, excruciating exercise ofredundant paperwork, complex authorization procedures, hours ofunbillable time, and frequent denials.
As it stands, on July 1 the vast majority of provisionally licensedtherapists will be forced by DMA to interrupt their outpatient therapywork. This decision was made over the clear objections of the mentalhealth professional organization (Professional Alliance Council) thatthe Division asks for guidance on these issues.
Since there is still a severe workforce shortage in North Carolina,particularly in the rural areas, removing these very capable and much-needed therapists will plunge the system into further crisis. Fewertherapists providing these basic outpatient services will mean moreclients deteriorating to the point of requiring more intensive enhancedservices. The fact that there are not enough licensed therapists torefer these clients to will create a situation very shortly where therewill be hundreds of mental health clients in rural Western NorthCarolina losing their outpatient therapists. This scenario will also beplayed out in rural areas statewide. How is this going to improve thedelivery of services?
Also, relegating provisionally licensed therapists to only providingenhanced services will keep many recent graduates and many veryqualified therapists from wanting to come to North Carolina. Our statealready ranks near the bottom in mental health, and this will onlysolidify our reputation as a state that is bumbling its way towardobliteration of the mental health system with management decisions thatare not progressive or even helpful.
Most importantly, perhaps, I have yet to get an answer from DMA orDHHS as to why only physicians are being anointed in the new policy,and why a licensed psychologist is not being considered qualified to dothe same. Psychologists are expected to render the same decisions aboutmedical necessity for mental health services as a physician, yet we areconsidered unqualified to participate in the new policy.
The fact that after July 1 psychologists and other approved licensedprofessionals will still be required to provide supervision accordingto our various licensing boards requirements essentially makes us sharelegal and clinical responsibility for the provisionally licensedtherapists' work. Regardless, we are barred from employing them in ouragencies where we can refer to them and provide closer supervision andtraining.
I would also like to know where all of these participating physiciansare going to come from in the rural areas. Most are up to their necksin patients and expending all of their time serving their patients'medical needs and prefer to refer out to the mental healthprofessionals in the community when a mental health issue is suspected.The vast majority of physicians are not adequately trained in mentalhealth diagnosis and treatment, yet they are the ones that DMA hasdecided are now the most appropriate to directly supervise theoutpatient therapy work of provisionally licensed therapists?
In addition, why would a practicing physician want to further riskmalpractice litigation by allowing a provisionally licensed mentalhealth therapist to bill for services through his Medicaid providernumber? The only entities that this policy change will benefit are thegigantic mental health corporations that have deep enough pockets toafford their own psychiatrists. The smaller, truly community-basedagencies will be replaced by more impersonal, profit-driven mentalhealth Wal-Marts. The irony is that this is the type of situation thatreform attempted to correct in the first place.
At this point, any mental health agency in North Carolina stillfaithfully trying to provide needed mental health services for itscommunities deserves a medal. Many providers have left the state or thefield altogether, having grown weary of the ceaseless changes andincompetent leadership. Instead of policy changes that are going tofurther destabilize and demoralize us, include us in your decisions andlet's work together to create an inclusive system that works for usall.
(Raymond Turpin, PsyD, is the president and clinical director forHaywood/Jackson County Psychological Services. He can be reached atrturpin@jcpsmail.org.)
By Raymond Turpin • Guest Columnist
-Smoky Mt News
Provisionally licensed therapists are individuals who have completedtheir formal education and training, hold master's or doctoral degreesfrom accredited graduate programs, and lack only supervised hours ofpractical experience in order to qualify for their licensure exam. Foryears, they have been able to come to North Carolina and provide much-needed therapy services to Medicaid recipients while receiving adequatesupervision from licensed professionals in their respective fields.
They have helped offset ongoing, serious workforce shortages in thisstate, and their services are critical to providers statewide who aretrying to meet the mental health needs of their communities. Theiroutpatient therapy services continue to be vitally important to thesurvival of North Carolina's fragile mental health delivery system,which is still reeling after years of mismanagement by the verygovernment agencies entrusted with its care and development.
In a continuance of puzzling decisions, North Carolina's Division ofMedical Assistance has announced that beginning July 1, provisionallylicensed therapists will no longer be able to provide outpatienttherapy for Medicaid recipients unless they work for a physician,accept only mental health referrals from said physician, and deliverall services on-site where the physician practices medicine. Thephysician is responsible for supervising the therapy, but provisionallylicensed therapists must still seek supervision from approved licensedprofessionals in their field in order to accrue hours towardslicensure.
If a provisionally licensed therapist does not work directly under aphysician, they will only be allowed to provide Medicaid's "enhanced"services, which consist of the services such as Community Support thatthe state has mismanaged into a confusing, excruciating exercise ofredundant paperwork, complex authorization procedures, hours ofunbillable time, and frequent denials.
As it stands, on July 1 the vast majority of provisionally licensedtherapists will be forced by DMA to interrupt their outpatient therapywork. This decision was made over the clear objections of the mentalhealth professional organization (Professional Alliance Council) thatthe Division asks for guidance on these issues.
Since there is still a severe workforce shortage in North Carolina,particularly in the rural areas, removing these very capable and much-needed therapists will plunge the system into further crisis. Fewertherapists providing these basic outpatient services will mean moreclients deteriorating to the point of requiring more intensive enhancedservices. The fact that there are not enough licensed therapists torefer these clients to will create a situation very shortly where therewill be hundreds of mental health clients in rural Western NorthCarolina losing their outpatient therapists. This scenario will also beplayed out in rural areas statewide. How is this going to improve thedelivery of services?
Also, relegating provisionally licensed therapists to only providingenhanced services will keep many recent graduates and many veryqualified therapists from wanting to come to North Carolina. Our statealready ranks near the bottom in mental health, and this will onlysolidify our reputation as a state that is bumbling its way towardobliteration of the mental health system with management decisions thatare not progressive or even helpful.
Most importantly, perhaps, I have yet to get an answer from DMA orDHHS as to why only physicians are being anointed in the new policy,and why a licensed psychologist is not being considered qualified to dothe same. Psychologists are expected to render the same decisions aboutmedical necessity for mental health services as a physician, yet we areconsidered unqualified to participate in the new policy.
The fact that after July 1 psychologists and other approved licensedprofessionals will still be required to provide supervision accordingto our various licensing boards requirements essentially makes us sharelegal and clinical responsibility for the provisionally licensedtherapists' work. Regardless, we are barred from employing them in ouragencies where we can refer to them and provide closer supervision andtraining.
I would also like to know where all of these participating physiciansare going to come from in the rural areas. Most are up to their necksin patients and expending all of their time serving their patients'medical needs and prefer to refer out to the mental healthprofessionals in the community when a mental health issue is suspected.The vast majority of physicians are not adequately trained in mentalhealth diagnosis and treatment, yet they are the ones that DMA hasdecided are now the most appropriate to directly supervise theoutpatient therapy work of provisionally licensed therapists?
In addition, why would a practicing physician want to further riskmalpractice litigation by allowing a provisionally licensed mentalhealth therapist to bill for services through his Medicaid providernumber? The only entities that this policy change will benefit are thegigantic mental health corporations that have deep enough pockets toafford their own psychiatrists. The smaller, truly community-basedagencies will be replaced by more impersonal, profit-driven mentalhealth Wal-Marts. The irony is that this is the type of situation thatreform attempted to correct in the first place.
At this point, any mental health agency in North Carolina stillfaithfully trying to provide needed mental health services for itscommunities deserves a medal. Many providers have left the state or thefield altogether, having grown weary of the ceaseless changes andincompetent leadership. Instead of policy changes that are going tofurther destabilize and demoralize us, include us in your decisions andlet's work together to create an inclusive system that works for usall.
(Raymond Turpin, PsyD, is the president and clinical director forHaywood/Jackson County Psychological Services. He can be reached atrturpin@jcpsmail.org.)
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