Issue Summary:

•  Memorandum of Agreement Relative to Older North Carolinians with a Developmental Disability Between the North Carolina Department of Health and Human Services’ Division of Aging, Division of MH/DD/SAS and Division of Social Services.   Based on the Associations recommendation, a workgroup was formed with representatives of County DSS and other players to revise MOA.   Revision did occur and was presented to our committee for review this date. The role of DSS was reformatted from the earlier agreement and all references to guardianship were deleted.   Joint goals and objectives were outlined and it was agreed that nothing in the MOA would permit any party to determine the availability of resources, etc. for any other party. It was suggested that the need for the MOA be stated before the descriptions of the different divisions.   With that change, we accepted the MOA as presented to be signed by the 3 Division Directors pending approval of the NCACDSS Executive Board.

•  SA Demo Expansion was supported in prior Executive Board motion.   Legislation as introduced from the Aging Study Commission kept the expansion as a demonstration project.   Several advocacy groups have been meeting to get a substitute bill introduced and we have been part of that dialog. The only difference in the bill and what we originally supported is the cap figure of 2000 (before it had been an expansion of 1600) which counts the nearly 400 current participants. The group has asked our Association to go on record as a supporting organization.   Our committee is in support of this bill and referred it to Advocacy for review in their meeting.   We will defer to them for an action recommendation.

•  Placement of individuals in adult care homes who have mental health problems and the challenges and risks it creates.   Our committee invited the Division of Facility Services for a dialog about impact of Mental Health Reform on adult care homes, penalty issues, and application of compliance history portion of Senate Bill 10.   In the discussion, it was recognized that we needed to be at the table in the Cost Modeling workgroup and the Family Care workgroup that the Department currently has meeting.    Our insight at the local level about service issues and cost concerns need to be part of the discussions.   The Senate Bill 10 issues have been hard to implement and they will be referred to the currently functioning Rules Review Committee that Judy Pelt represents us on.   DFS needs to do regular ongoing training about putting together the information needed for penalty recommendations and documentations that will hold up in the various hearings that occur.   This hasn’t been done for at least 3 years.   They will make it part of their regular training.   It was clear as it related to mental health and adult care homes/family care homes that the issues were many and everyone had different information.   Rather that containing to complain, it was recommended that we get proactive and develop a position paper that could be presented to the Department and others for action.

•  Potential funding cuts were discussed and referred to Advocacy for action.   We all agreed we needed to help our legislators understand the implications.

Position or Policy Recommendation for Board Action:

•  Recommend that a letter be drafted to Division Director removing any opposition to the signing of the MOA.

•  Recommend the Association develop a position paper to be presented to the Department that defines the problems created by the placement of individuals with mental health diagnoses in adult care and family care homes and offer recommendations to address these problems.   Members of this workgroup should include NAMI, ARC, Friends of Residents, Adult Foster Care Association, Ombudsman, etc.  

General Information for Dissemination:

Counties are encouraged to send Adult Home staff to all DFS training.   There is still a problem with attendance.

Community Care of North Carolina (Access II/III) is expanding into other counties and joins hospitals, health departments, social services and physicians in improving quality of care, utilization and cost effectiveness for the Medicaid population.   Currently focusing on Asthma, Diabetes, Emergency Care, Pharmacy and targeting care management to those high risk/high dollar patients.   Project 16 networks statewide and 655,000 clients enrolled by 6/30/05.   Networks will have 30-50,000 enrollees.