Just last week we heard about the very fast expansion of the Medicaid Waiver.  While there are positives, moving too fast on anything can lead to chaos in the system.  We had only hoped that perhaps the offering of cost containment through a waiver might stave off further cuts to our mental health system that has gone through so much.  And we had felt that we were moving in a good direction- more stability on the provider side through forced economies of scale through the CABHA requirements.  But no, we are being hit- a double whammy - by cuts that are being offered up by the General Assembly, and by an expansion of the waiver in a very rapid manner.

What are the recommended cuts? 

Overall, there are shocking cuts to our state's educational system- both public schools, universities, and community colleges.  And there are cuts to preschool education and other areas.  But the focus here is on cuts to mental health. 

And an aside- there are more ways to close a budget gap of nearly 3 billion than strictly by cuts.  Unfortunately, that is the main approach reflected in the legislative figures put forward here.  The cuts to the HHS budget is ll% in total, or $527 million.  Health and Human Services (HHS) is bigger than just mental health, it incorporates DSS, Health, and a variety of other departments.  The legislature adopts a biennium- two year budget, for 20-112012 and 2012-2013

Division of MHDDSAS Cuts:

1.  Local Management Entity Administration -( l7% cut, l0 M first year 2011; 20 M cut second year; over and above Governor's recommendations)

2.  Eliminate 7 Advocacy positions - 5% reduction

3.  Eliminate Community funding spent for Medicaid recipients except for residential supports (20M first year of the biennium)

4.  Swap fund balance with state service dollars (25M cut in first year of biennium)

5.  Reduce Division management flexibility funds (7.8M cut in both years of the biennium

Tota Division Cut:  (9.4%, 68M first year, 33M second year )

Cuts in the Division of Medical Assistance (DMA) area that may impact those with mental illness

1.  Rate cuts (60M first year; 63 M second year)

2.  Modify pharmacy services (l5M first year, 19M second year)

3.  Modity optional and mandatory Services

4.  Adjust provider rates (50M and 42M)

5.  Generic substitution drugs (7M second year)

6.  Waiver savings (3.2M year one; 38M year two)

7.  Community Care of NC (CCNC) savings (80M year one; 80 M year two)