Senate Bill 756 - Ammend Bail Law/Pretrial Release Programs -

Thank you to NAMI Wake for alerting us to this disaster in the making- this bill would eliminate unsecured bonds in NC and would ban pretrial service programs from contacting people (like people with mental illness) for 72 hours/3 days, and includes a mandatory bail bond of $l000.00  We all know that people with mental illness are all too often arrested for exhibiting illness symptoms, not crimes.  We understand that this bill would solely increase the profit margin of the for profit bail bond industry, and does nothing for public safety.  Many of you have had loved ones in jail - they have to wait for a hearing, during which time they can only have contact with the pretrial services staff.  And that contact would go away if this bill passes.

Who are you going to call? - your legislator, but also especially important are affiliates in the areas where the primary bill sponsors live:  Debbie Clary (Rutherford Cleveland), Don East (Allegheny, Stokes, Surry, Yadkin), Ed Jones (Bertie, Gates, Chowan, Halifax, Hertford, North Hampton)

Co sponsors:  Doug Berger, Harry Brown, James Forrester, Kathy Harrington, Ralph Hise, Bob Rucho, Tommy Tucker.

Action- call your legislator today and ask him/her to oppose SB 756 which has passed the second and third reading in the Senate, and passed its first reading in the House on 6/8/2011. The House Judiciary C meets Wednesday June 15 in Room 415, Legislative Office Building.  Chairman is T. Moore (Cleveland  Tim.Moore@ncleg.cnet). Co chair is Jonathan Rhyne, Lincoln Co. Jonathan.Rhyne@ncleg.net Or- come to the committee meeting!

The Budget

First there was the House Budget, then came a far worse Senate Budget, through the political process lots of concessions were made to bring the Senate budget around to a similar budget to what the House presented.  All this has been covered before- it still has a 2% rate cut to all providers (medicaid dollars) which follows years of fairly draconian cuts.  Then there are the LME cuts, the requirements that all LMEs have a population of 500,000 by July 2013, and the mandatory waiver environment.  With luck, we can use that to shape our service delivery system to be what it should be for people living with mental illness.  The Governor vetoed the budget this weekend.  Next step- are there the votes to override her veto in the House and Senate? 

Some positives- thanks to your calls and emails, the protection of mental illness drugs from the prior authorization requirements continues- language keeping this exempt from that extra barrier has been put back into the budget.

Adult Care Homes

This is yet another threat that may present an opportunity as well. The Centers for Medicare and Medicaid Services (CMS) has determined that the adult care home industry in NC of over l6 beds serving people between the ages of 22 and 65 may meet the Institution of Mental Diseases definition which means they cannot bill Medicaid- that has always been what has been called "the IMD exclusion".  They are excluded from medicaid if more than 50% of their beds are for people with mental illness or substance abuse.  And remember, medicaid is actually their health insurance, so we want no one to lose that!! The adult care homes are billing for personal care, then of course those individuals may get particular behavioral health services as well.  The state believes that there are around 38 facilities that could be in danger due to high number of people with mental illness and substance abuse.

So what is happening?

1. The Division of Mental Health is working on completing assessments of individuals living in Adult Care Homes to see if they meet the definition of MI or SA.  It includes a special housing choice addendum.  There are 1276 people in need of assessments, and another 700 who have recent assessments that can be used
2. They will then calculate the percentage and determine if the facility is an IMD
3. The assessors and the LME staff will together work on a plan for transition, if that is what is needed.
4. Questions remain on how people would be selected for transition - choice?  finances?  closer to family?  more appropriate settings?
5. Resources are being developed - including a web based existing housing search option and a Housing Resource Inventory
6. HB 509 - to allow two people to rent a home and receive services without licensure is probably going to pass- it opens up more options
7. Family Care Homes may be an option - generally 5 to 6 beds so under the threshold of an IMD
8. Stakeholder work group has met and will continue to meet on solutions- NAMI NC is at the table.  We're looking at ideas like changing the rules for Special Assistance to open that up for people to use in housing of their choice.
9. The Division/DMA will be putting together a restructuring/housing plan to address the IMD issue, in coordination with the Feds through CMS

Let NAMI NC know if you feel your family member is in danger of losing their bed.  Our hope is that we can advocate for more appropriate choices- especially for younger people who didn't really choose to live in a room and board option designed for people with health needs who are generally older.  We have let our citizens down by not having in place an appropriate continuum of housing options for people with mental illness.  But at the same time, there are people who would choose to stay- and that should be their choice.  Call Gloria Harrison at our helpline 1-800-451-9682 for help.

LME re-combinations- what's the latest?

ECBH

Sandhills

Wake

Smoky

Western Highlands

Mecklenburg

Centerpointe

Durham-Guilford-Cumberland-Johnston

PBH-OPC-Five County- Alamance Caswell

Eastepoint-Beacon-SE REgional

SE- Onslow Carteret

Pathways-Crossroads-MH Partners

This information is based on the waiver submissions whereby LMEs had to indicate how they would achieve the 500,000 required population by July 2013