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Directors, NCSSA, NCACBSS,
Below is a list of priorities that the Consortium will be endorsing to the
conferees. Some talking points have been including on each.
A list of conferee members follows the priority listing below. The members
of the Health & Human Resources conferees are: Senators Purcell, Reeves,
Dannelly, Kerr. The House members are: Reps. Nye, Alexander, Howard, Gorman,
Daughtridge. They met this week to review the difference in the budget. Discussions
will begin next week in earnest to begin crafting the compromise budget.
1. MAINTAIN Funding for Adult Home Specialist Fund /
Adult Care Home Case Management
Adult Home Specialist Fund
The House budget eliminates the state appropriation for this program from
$1,400,000 to $0. With this elimination of state funds the county DSSs will
no longer receive an allocation of state funds to provide this service.
Adult Homes Specialists in the county DSSs will be reduced from 133 to 91
positions. Workloads will increase from 14 to 25 facilities per worker. This
will significantly reduce the capacity of county DSSs to monitor the 1,300
adult care homes and family care homes with 39,000 beds for compliance with
state licensure standards, limit their ability to help facilities develop
corrective action plans when they are out of compliance with state licensure
standards, and reduce their ability to follow up to assure that facilities
correct deficiencies that affect resident health, safety, and well being.
The residents’ personal health and safety will be at greater risk.
Adult Care Home Management
The House budget reduces the state appropriation for this program from $1,539,206
to $539,206 for the next biennium. If the House budget is approved, this means
that the total budget for this program will be reduced from $6,156,824 to
$2,156,824. With this reduction in state funds, the allocation of state funds
to each county DSSs will be reduced by 66%.
Reducing the total budget from $6,156,824 to $2,156,824 will have a very significant
impact on the ability of county departments of social services to carry out
the duties required by state law and APA rules. This represents a 66% reduction
in the budget that will translate into a 66% reduction in counties’
staff capacity to do this work. The number of case managers will be reduced
from 70 to 24 statewide. This raises a serious concern about how the work
will be carried out. The $539,206 will be allocated to the 95 counties with
adult care homes, but it will obviously match only 33% of the amount currently
matched with the state appropriation. The logical outcome is that the service
cannot be provided to the same level of effectiveness and with the same timeliness
that it is currently provided. If this budget reduction is made, it will be
very difficult for the county DSSs to carry out the prior approval process
required by Medicaid for facilities to get the higher reimbursement for the
5,500 heavy care residents who get enhanced personal care services, to assure
that the heavy care residents are getting the additional hours of personal
care services the facilities are being reimbursed to provide, and for the
case managers to obtain the badly needed community-based services that improve
the quality of life and comfort for these residents.
2. MAINTAIN Medicaid coverage for pregnant women and
infants w/incomes between 151% and 185% of federal poverty ($22,530 for a
family of three).
The House budget cuts Medicaid funding to women and children in this demographic.
The total cut is $2.185 million in 03-04 and $9.258 million in 04-05. The
Senate budget contains no such cuts. 10,890 low-income pregnant women in families
with incomes over 150%FPL [$22,530 -family of three] will be denied access
to Medicaid health coverage, including prenatal care. Pregnant women can currently
get affordable Medicaid coverage if their family income is at or below 185%
FPL [$27,787 - family of three] and they have no other health insurance. Women
who don't get prenatal care are much more likely to have babies that are born
prematurely or who have serious health problems. Costs of caring for just
a few premature births with complications in a pediatric intensive care unit
can easily run into the millions of dollars. The costs of not providing adequate
prenatal care [and not covering infants - see below] far outweigh the $2 million
savings in this year's budget that comes from cutting this care. Infants less
than one year old will be denied Medicaid health coverage in families with
incomes over 150% FPL [$22,530 -family of three]. Currently Medicaid covers
infants less than one year old if their family income is at or below 185%
FPL [$27,787 - family of three] and they have no other health insurance. There
are over 800,000 children on the Medicaid program. Even if this change only
affects 10% of children on Medicaid, 80,000 children will be denied health
coverage under the House budget. The critical year for covering children is
their first year of life when many health problems can develop that are easily
treatable if caught early.
3. INCREASE N.C. Health Choice by Senate Recommendation
of $13M.
The House budget would increase NCHC funding by $7.7 million, maintaining
enough funding for 100,000 children. The Senate budget would increase NCHC
funding by $13 million in 03-04 and $19.1 million in 04-05.
The recommended funding by the House would result in 20,000 children being
denied Health Choice -- affordable health insurance for children of modest-income
working parents. Enrollment will be limited to 100,000 children, excluding
at least 5,000 children next year and 15,000 more over the next three years.
An enrollment freeze would occur right after the state budget is final.
4. INCREASE Foster/Adoption Reimbursement Rate by $50
for each age group.
The House budget includes a $3 million line-item to increase the foster care
reimbursement rate by $50 across the board. The Senate budget includes the
same allocation. Originally, the House called for a $100 across-the-board
increase; the house had asked the legislative staff for the amount needed
to cover this increase but the figure was not accurate. When DHHS compiled
the numbers they found that the $3million state increase would only provide
for a $50 increase.
The foster/adoption reimbursement rate has not been increased since 1994.
North Carolina is second only to South Carolina in providing the lowest reimbursement
rate in the South East. The rate to board a mid size dog in a kennel is more
in our state then the rate to cover the cost of care for our children in foster
care. Supportive foster and adoptive families move children from destructive,
even criminal, paths to healthy ones. (Juvenile incarceration costs NC $52,000
annually, or $4,333 monthly.) We save our children and we save money by recruiting
and retaining good foster/adoption parents.
5. MAINTAIN Medicaid coverage for 19 and 20-year-olds
The House budget would eliminate Medicaid funding for 19- and 20-year-old
foster kids, cutting a total allocation of $2 million for 03-04 and $3.5 million
for 04-05. The Senate budget includes no such cuts.
Many foster children remain under care when they are 19 and 20 years old to
continue support that will assist them in finishing school, attending college,
and securing employment. This would eliminate health coverage for our foster
children during this critical transitional time.
6. MAINTAIN Transitional Medicaid coverage for those
coming out of the Work First program
The House eliminates the 12-month transitional period of coverage for those
coming off of Work First, cutting $412,322 in FY 03-04 and $21,235,628 in
04-05. The Senate dropped this cut in its budget. Losing health coverage,
especially for serious family health problems, is a powerful disincentive
to join the workforce and lose Medicaid coverage. Most jobs wage earners in
NC are taking as they move off of welfare do not even offer, much less provide,
health coverage. This change means we are turning our back on a basic component
of welfare reform - we want people to join the workforce, but we don't want
to give them the support they need to succeed. This change means more families
on welfare in North Carolina.
7. MAINTAIN Current rate of Prescription drug co-payment
The House budget cuts Medicaid prescription drug funding by $4.4 million.
The Senate budget includes no such cut. The House budget would raise the Medicaid
co-payment from $1 to $3. For many of the families we serve, the increase
could have serious financial ramifications. The Medicaid coverage allows up
to 6 prescriptions. If a single mother has several children who each requires
multiple prescriptions this additional cost could be more than financially
possible. The same applies for elderly on a fixed income. Many of our elderly
clients require all 6 allowed prescriptions. An additional $18 dollars represents
a significant amount on a fixed budget.
PLEASE CALL OR EMAIL THE FOLLOWING KEY MEMBERS OF THE
BUDGET CONFERENCE COMMITTEE;
Make it a priority to contact these
legislators first:
(All phone numbers are in the 919 area code; All members can also be reached
by calling 919-733-4111)
Speaker of the House Jim Black (D-Charlotte): 733-3451 Jimb@ncleg.net
Speaker of the House Richard Morgan (R-Moore): 715-3010 Richardm@ncleg.net
Dem Leader Joe Hackney (D-Orange) joeh@ncleg.net 733-5752
Rep Leader Joe Kiser (R- Catawba, Gaston, Lincoln) Joek@ncleg.net 733-5782
Senate President Pro Tempore Marc Basnight (D-Dare) marcb@ncleg.net 733-6854
Senate Majority Leader Tony Rand (D-Cumberland) Tonyr@ncleg.net 733-9892
House and Senate Finance Committee Leaders:
Rep. Gordon Allen gordona@ncleg.net 919-733-5662
Rep. Paul Luebke paull@ncleg.net 919-733-7663
Rep. Julia Howard juliah@ncleg.net 919-733-5904
Rep. Danny McComas dannym@ncleg.net 919-733-5786
Rep. David Miner Davidm@ncleg.net 733-5934
Rep. William Wainwright williamw@ncleg.net 919-733-5995
Sen. David Hoyle Davidh@ncleg.net 919-733-5734
Sen. John Kerr Johnk@ncleg.net 919-733-5621
House and Senate Appropriations/Base Budget Committee Leaders:
Rep. James Crawford, Jr, jimcr@ncleg.net 919-733-5824
Rep. Wilma Sherrill wilmas@ncleg.net 919-715-3026
Sen. Linda Garrou lindag@ncleg.net (919) 733-5620
Sen. Walter H. Dalton walterd@ncleg.net (919) 715-3038
Sen. Kay R. Hagan kayh@ncleg.net (919) 733-5856
If you know other members of the Budget Conference Committee, please contact
them as well:
Rep. Martha B. Alexander 919-733-5807 Marthaa@ncleg.net
Rep. Rex L. Baker 919-733-5787 Rexb@ncleg.net
Rep. Harold J. Brubaker 919-715-4946 Brub@ncleg.net
Rep. E. Nelson Cole 919-733-5779 Nelsonc@ncleg.net
Rep. William T. Culpepper, III 919-715-3028 Billc@ncleg.net
Rep. W. Pete Cunningham 919-733-5778 Petec@ncleg.net
Rep. Bill G. Daughtridge, Jr. 919-733-5802 Billd@ncleg.net
Rep. Beverly M. Earle 919-715-2530 Beverlye@ncleg.net
Rep. Jean Farmer-Butterfield 919-733-5898 Jeanf@ncleg.net
Rep. Stanley H. Fox 919-733-5758 Stanf@ncleg.net
Rep. Michael A. Gorman 919-715-3019 Michaelg@ncleg.net
Rep. W. Robert Grady 919-715-9644 Robertg@ncleg.net
Rep. R. Phillip Haire 919-715-3005 Philliph@ncleg.net
Rep. Maggie Jeffus 919-733-5191 Maggiej@ncleg.net
Rep. Carolyn H. Justice 919-715-9664 Carolynju@ncleg.net
Rep. Stephen A. LaRoque 919-715-3017 Stephenl@ncleg.net
Rep. William C. McGee 919-733-5747 Williamm@ncleg.net
Rep. Edd Nye 919-733-5477 Eddn@ncleg.net
Rep. William C. Owens, Jr. 919-733-0010 Billo@ncleg.net
Rep. John I. Sauls 919-715-3012 Johns@ncleg.net
Rep. Bonner L. Stiller 919-733-5974 Bonners@ncleg.net
Rep. Joe P. Tolson 919-715-3024 Joet@ncleg.net
Rep. Keith P. Williams 919-715-3009 Keithw@ncleg.net
Rep. Thomas E. Wright 919-733-5754 Tomw@ncleg.net
Rep. Douglas Y. Yongue 919-733-5821 Douglasy@ncleg.net
Sen. Charles W. Albertson (919) 733-5705 Charliea@ncleg.net
Sen. Daniel G. Clodfelter (919) 715-8331 Danielc@ncleg.net
Sen. Charlie Smith Dannelly (919) 733-5955 Charlied@ncleg.net
Sen. Wib Gulley (919) 715-3036 Wibg@ncleg.net
Sen. Jeanne Hopkins Lucas (919) 733-4599 Jeannel@ncleg.net
Sen. Stephen M. Metcalf (919) 733-5707 Stevem@ncleg.net
Sen. William R. Purcell (919) 733-5953 Williamp@ncleg.net
Sen. Eric Miller Reeves (919) 715-6400 Ericr@ncleg.net
Sen. A. B. Swindell (919) 715-3030 abs@ncleg.net
Sen. Scott Thomas (919) 733-6275 scottt@ncleg.net
Sen. David F. Weinstein (919) 733-5651 Davidw@ncleg.net
