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NCACC E-News Updates Oct. 20, 2005 Barnes testifies that county concerns not being heard in Mental Health Reform NCACC President Kitty Barnes (Catawba County) testified Wednesday at a meeting of the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities and Substance Abuse Services. The oversight committee, which is co-chaired by Sen. Martin Nesbitt (Buncombe) and Rep. Verla Insko (Orange) met in Buncombe County. The $28 million shortfall in Medicaid funding – and the Department of Health and Human Services’ plan to make up for the shortfall by consolidating Utilization Review into 10 Local Management Entities – was a major topic of discussion at the meeting. Barnes noted that the department approved each LME’s business plan, and that no mention of the need for additional savings was made during this process. Nesbitt also expressed frustration that the DHHS did not alert the General Assembly to the $28 million shortfall until after the session had adjourned and it was too late for legislators to make any adjustments to the budget. The budget for 2005-06 left millions of dollars of projected revenues unspent. According to officials from the DHHS, the department has decided to restore the $14 million it had proposed cutting from LMEs beginning in January, but it still appears as if the department plans to implement the $28 million in cuts for 2006-07. Barnes also told the oversight committee that counties had been left out of the mental health reform planning for the last two years even though counties have a vested interest in the process through the provision of jails, administrative services, Medicaid funding and other mandates from the General Assembly. Nesbitt also criticized the DHHS for not communicating better with the oversight committee and with counties. Barnes’ testimony comes on the heels of a meeting Oct. 14 between Durham County Board of Commissioners Chair Ellen Reckhow, DHHS Secretary Carmen Hooker Odom and members of the N.C. Council of Community Programs in which Reckhow relayed county concerns with the proposed cuts. For more information on the Joint Legislative Oversight Committee meeting, click here to read the article in the Asheville Citizen-Times. Oct. 5 NCACC seeks individuals for steering committees The Association’s seven steering committees provide guidance and recommendations on policy issues to the Board of Directors. The steering committees (Public Education, Environment, Criminal Justice, Human Resources, Agriculture, Taxation and Finance, and Intergovernmental Relations) meet regularly to gather and consider information on emerging county-related issues. The steering committees provide the greatest opportunity for individual county commissioners to get more involved within the Association. Membership on the steering committees is open to all county commissioners as well as county staff who might have a particular interest or expertise. The Association staff provides administrative and technical support to each committee If you are interested in serving on a committee, please fill out our form and mail it to the NCACC. Click here for a printable form. Click the link below to see the current roster and policy statement for each committee: www.ncacc.org/committees/steering.html RMP safety program seminars begin Oct. 26 The NCACC Safety Program “Implementing an Incident Investigation Program and Accident Review Board” targets safety coordinators, HR managers and other supervisors or managers with interest in learning how to implement an effective safety program. Do your managers know how to investigate incidents? Do they understand that all accidents are caused, and can be prevented? Are investigations in-depth so we really know what happened? Are corrective actions taken as the result of each investigation? Do managers know the types of corrective actions needed to prevent recurrence of a future incident? These and other questions will be answered in this “train the trainer” Incident Investigation session. Click below for seminar dates, locations and directions. The seminars are free to members of the Risk Management Pools. To register or request a copy of the seminar manual, contact Amy Kunkle at (919) 719-1108; via fax at (919) 719-1101 or e-mail at amy.kunkle@ncacc.org. Those planning to attend should register at least 15 days prior to the date of the sessions. A copy of the registration form is attached to this e-mail. www.ncacc.org/rmp-safetyseminars_0905.html CMS to extend filing deadline for Medicare Part D Employer Subsidy Application The Centers for Medicare & Medicaid Services (CMS) has indicated that it will extend the deadline for employers to file their Medicare Part D Employer Subsidy applications from Sept. 30 until Oct. 31, 2005. Medicare Part D is the prescription drug program that will become effective Jan. 1, 2006. Under Medicare Part D, CMS-approved prescription drug plans will offer a basic drug benefit to eligible retirees for a monthly premium that is expected to average approximately $32. Retirees may enroll in Medicare Part D benefits beginning Nov. 15, 2005. Applications for the subsidy can be found on the CMS Web site (www.cms.hhs.gov) and must be filed electronically through the Web site. Click below for more information: www.ncacc.org/rmp-partdnotice.html Sept. 27, 2005 Mental Health Cash Flow Problems Last week the NCACC was involved in discussions regarding possible imminent funding reductions to the area mental health programs for management functions. The secretary of Health and Human Services is proposing significant funding reductions to the Mental Health, Developmental Disabilities and Substance Abuse Services Local Management Entities (LME’s) in the current fiscal year in response to a cash flow shortage caused by deficiencies in the cost model used to predict program management resource needs. The LME cost model, developed several years ago when mental health reform was just beginning, assumes consolidation of the 39 former area mental health programs into no more than 20 management entities by 2007. The number of LME’s has been reduced to 33 over the past few years, with two more consolidations scheduled to take place by July 2006. Larger management entities theoretically result in economies of scale. Because consolidations are not moving as rapidly as hoped by DHHS, the available funds are not sufficient. The department’s proposed solution to the funding shortage is to contract with no more than 10 LME’s for two specific functions: Utilization Review (UR) and Screening, Triage and Referral (STR). The secretary proposes to solicit proposals from the LME’s to provide these two functions statewide. Currently, the UR function is handled two ways:
All LME’s provide Screening, Triage and Referral services, which is a telephone-based service providing 24-hour access to providers. Regional approaches to STR have been piloted in some area mental health programs in recent years. In last week’s meeting with Secretary Carmen Hooker Odom, the department proposed to reduce management payments to all LME’s not selected to perform UR/STR functions effective with the January 2006 payments. At week’s end, the area mental health programs held a quickly called meeting to discuss a collective response to this proposal. Program representatives, including many county commissioners who serve on the area program boards, were outraged. The NC Council for Community Programs, headed by Executive Director Carol Duncan Clayton, is especially concerned about lack of adequate funding for services, insufficient provider capacity in some areas, and other issues that need to be addressed before management functions are arbitrarily combined. The NC Council is concerned that a reduction in management funds might have impact on service monitoring and delivery given the stresses in provider capacity. The NCACC is equally outraged. Consolidation of functions is intended to be addressed in the local business planning process, which the Department of Health and Human Services oversees. Savings resulting from consolidation are intended to be maintained in the services system to meet the growing community needs caused by downsizing of the state psychiatric facilities. NEXT STEPS: The Department of Health and Human Services is re-evaluating their proposal to see whether the timeline can be modified. The NC Council of Community Programs is meeting again this week to develop more strategic alternatives that address the funding deficiencies and other concerns. NCACC Executive Director David Thompson and Deputy Director Patrice Roesler are scheduled to meet with Division Director Mike Moseley next Monday. Hopefully, a more positive outcome will result from these deliberations. We will keep you posted as events take place. Should you have any questions, please do not hesitate to call. Sept. 14, 2005 National conference to address children exposed to Meth abuse Children living in dangerous drug environments are at higher risk for a variety of problems as they grow up. These problems often lead to them repeating the cycle of drug abuse and poverty. The National Alliance for Drug Endangered Children is sponsoring a conference Oct. 3-5 in Washington, D.C., to heighten awareness for these often-forgotten victims of drug abuse. The Drug Endangered Children program is a multi-disciplinary approach that involves law enforcement, child welfare, medical professionals and prosecutors to rescue, defend, shelter and support children exposed to methamphetamine. One of NACo President Bill Hansell’s major initiatives is combating the rising abuse of methamphetamine. The Meth Epidemic in America, a report recently released by NACo, generated substantial national publicity and contains information from two surveys: The Criminal Effect of Meth on Communities and the Impact of Meth on Children. For more information about the conference, including a downloadable registration form and accommodations information, Click on the link below: www.nationaldec.org/Conference/conference.htm NCACC to host educational workshops on Debt Setoff Program The North Carolina Association of County Commissioners will host a series of educational workshops on the Debt Setoff Program beginning next week. The program is jointly administered by the NCACC and the N.C. League of Municipalities and allows participating local governments to submit outstanding debts to the N.C. Department of Revenue in an effort to offset those debts with debtors who are due to receive state income tax refunds. Since the program’s inception in 2001, more than $15 million has been returned to local governments in North Carolina. Gaston County has received more than $1 million in 2005 alone, and Wake County and Cleveland County have recovered almost $1 million apiece since joining the program. For more information about the training programs, click on the link below: www.ncacc.org/debtsetoffws_0905.html Sept. 1, 2005 Estimated lottery proceeds for school construction The NCACC Board of Directors considered the lottery issue at its Feb. 23, 2005, meeting and voted to support local option lotteries with a substantial portion of the proceeds to be dedicated to local school construction. We are pleased that the General Assembly has recognized the need for additional school construction funding - the Association’s third highest legislative priority - and has pledged substantial lottery proceeds for school capital projects. Please note that the county allocation mechanism was devised solely by the General Assembly. Please find below the distribution method for the lottery’s net revenues and an estimate of lottery proceeds for school construction by county. Our many thanks to the General Assembly’s fiscal research staff for providing these projections. Please note that the projections are based on current effective tax rates and ADM counts. Net revenues (after expenses and prizes) from lottery receipts distributed as follows:
Public School Building Capital Fund lottery monies allocated as follows:
*Allocation mechanism devised solely by General Assembly. Public School Building Capital Fund lottery monies to be used as follows:
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