A number of interim committees met this week with one common thread running throughout the conversations: health. Committees discussed issues including the vocational training and support for individuals with intellectual and developmental disabilities (IDD) and an update on the status of NC’s Medicaid waiver application. Additionally, the filing deadline for the 2018 elections passed on Wednesday.

Filing for 2018 Elections Ends

Candidate filing for 2018 elections ended on Wednesday afternoon. All 170 seats in the state legislature, and 13 seats in US Congress will be on the ballot, as well as a number of county officials. Primaries will be held on May 8 and the general election will follow on November 6.

Click here for a 2018 candidate tracker from the NC FreeEnterprise Foundation.

Record Number of Contested Legislative Races

After a strong push from the Democratic Party to have one candidate on the ballot in every House and Senate district in the 2018 elections, only one legislative seat will be uncontested in November. This stands out in contrast to recent years, the 2016 election cycle included 73 uncontested legislative seats. Officials of both parties expressed excitement about the competitive nature of the upcoming election cycle.

More Primaries for Legislative Incumbents

In 2016, eight incumbent senators, four from each party, faced primaries. In 2018, nine Republicans and three Democrats will have primaries. On the House side, 19 Republicans and eight Democrats will face primary opponents this year. Two years ago, eight Democrats and seven Republicans had primaries.

While incumbency was considered when the state’s legislative maps were redrawn in 2017, several members are double-bunked in 2018:

  • In Senate District 45, Republican Sens. Deanna Ballard (Watauga) and Shirley Randleman (Wilkes) will compete in a two-way primary.
  • There will be a three-way primary featuring Republican Sens. Dan Barrett (Davie), Joyce Krawiec (Forsyth) and newcomer Peter Antinozzi in Senate District 31.

What About Congressional Elections

NC’s 2018 congressional races also have potential to be competitive. Twelve of the 13 seats will be contested and more than 60 candidates threw their name in the ring. The NC delegation is currently comprised of 10 Republicans and 3 Democrats. NC is considered by many to be a “purple” state, which will put these elections, the first since President Donald Trump took office, in the spotlight.

Behavioral Health Plan Discussed by Subcommittee

The Behavioral Health Subcommittee of the Joint Legislative Oversight Committee on Medicaid and NC Health Choice and the Joint Legislative Oversight Committee on Health and Human Services held their first meeting on Tuesday to discuss the statewide behavioral health plan that was submitted to the General Assembly by the Department of Health and Human Services (DHHS) in January.

What’s Included in the Plan?

DHHS Assistant Secretary for Policy Walker Wilson, Deputy Secretary for Health Mark Benton and Deputy Secretary for Medical Assistance Dave Richard overviewed the plan, and reviewed the current challenges facing the behavioral health system, including the opioid epidemic and unmet mental health care needs, particularly in rural areas of the state. Recommendations in the plan include:

  • Expanding the use of telemedicine.
  • Better utilizing the behavioral health service workforce.
  • Accelerating the integration of physical and behavioral health.
  • Increasing services for young children and support for their families.
  • Establishing or strengthening community collaboration.

Health & Human Services Oversight Receives Updates

The Joint Legislative Oversight Committee on Health and Human Services met on Wednesday.

DHHS Secretary Updates Committee

DHHS Sec. Mandy Cohen provided her remarks to the committee. She first highlighted actions the Department has taken to assist the transition of the Cardinal Innovations Board of Directors. Sec. Cohen reported that the Board has pledged to spend at least $3.8 million on an enhanced behavioral health initiative. The Secretary also addressed the 2017-18 flu season, noting that there have been 200 flu related deaths in the state this season.

Local Health Departments Present Legislative Priorities

President of the NC Association of Local Health Directors and Director of the Union County Health Department Dennis Joyner presented an overview of the responsibilities of local health departments and the challenges they face – primarily stretching small budgets to meet all of their obligations. Pitt County Health Director Dr. John Morrow noted that state funding for communicable disease has not kept pace with the number of outbreaks. According to Granville-Vance Health District Director Lisa Macon Harrison, NC ranks 44 in public health in per capita state spending.

Health in Prisons and Jails Reviewed

The committee heard two presentations on the protocols surrounding prison and jail inmate health.

First, DHHS Division of Health Service Regulation Construction Section Chief Steve Lewis presented an overview of the Department’s jail death oversight policies and procedures. The Construction Section conducts compliance reviews when jails report an “in-custody” death of an inmate. According to his presentation, 38 jail inmates died in 2017, the majority of which died of natural causes.

Then, Department of Public Safety Deputy Secretary of Administration Joe Prater presented a review of the inmate health care and the implementation of a health information exchange for inmates.

Intellectual & Developmental Disabilities Committee Reviews Workforce Inclusion

Yesterday, the Legislative Research Committee on Intellectual and Developmental Disabilities held their second meeting to hear presentations from DHHS and other organizations on the inclusion of individuals with an I/DD in the workplace.

DHHS & Organizations Overviewed Available Programs

In their presentation, the Department identified the needs of individuals with an I/DD transitioning from a K-12 environment to post-secondary education or work, highlighted available programs, and made several recommendations based on existing gaps, including:

  • Fostering attitudes of high expectations for youth with an I/DD beginning at birth.
  • Promoting understanding of the definition of competitive integrated employment within NC business community.
  • Increasing capacity for customized employment.

The committee also received presentations from the following stakeholders: The ARC of NC, The Autism Society of NC, Alliance Disability Advocates and OE Enterprises, all of whom emphasized the importance of empowering individuals with an I/DD through employment.

Medicaid Oversight Discusses 1115 Waiver

The Joint Legislative Oversight Committee on Medicaid and NC Health Choice held their third meeting of the interim on Wednesday, where they received updates from DHHS, including an update on the status of the state’s 1115 Waiver application.

What’s the Status of the Waiver?

First, Steve Owen of the NCGA’s Fiscal Research Division reviewed the amended waiver, including an overview of provisions that are not consistent with existing state law. DHHS Secretary Mandy Cohen, Dave Richard and DHHS Deputy Secretary for Policy Christen Linke Young followed with a review of the Department’s work with the federal Centers for Medicare & Medicaid Services (CMS). According to the presentation, DHHS and CMS have had ongoing meetings for months to discuss the waiver.

Anything Else?

Yes, the committee also received updates on Medicaid and NC Health Choice enrollment levels, including enrollment in the Family Planning program, finances, and an overview of Medicaid Dashboards. According to Steve Owen, enrollment has roughly tracked in line with expectations and is 3.6% higher than this time last year. Medicaid expenditures also continue to be favorable.

Medical Education Subcommittee Reviews Loan Repayment & Approves Committee Report

Yesterday, the Subcommittee on Medical Education and Medical Residency Programs, a joint subcommittee of the Joint Legislative Oversight Committee on Health and Human Services and the Joint Legislative Education Oversight Committee, held their second meeting of the interim. The committee heard presentations on loan repayment programs available to medical providers in rural NC and adopted their final report.

Loan Repayment Programs Encourage Practitioners in Rural NC

DHHS Office of Rural Health Director Maggie Sauer presented to the committee on existing state and federally supported loan repayment programs for health practitioners in rural areas of the state. Sauer emphasized that these programs are not a silver bullet and suggested expanding telehealth to improve health, employment and education in rural NC.

Subcommittee Report Proposes Medical Education & Residency Study

The subcommittee adopted their report, which overviews the committee’s activities and includes a legislative proposal to continue the work of the subcommittee in the interim between the upcoming short session and the 2019 long session. The report must be approved by both overseeing oversight committees.

A Look Ahead to Next Week

Monday, March 5, 2018

8:45 AM House Select Committee on Strategic Transportation Planning and Long Term Funding Solutions

Tuesday, March 6, 2018

9:00 AM Task Force on Sentencing Reforms for Opioid Drug Convictions

10:00 AM Joint Legislative Education Oversight Committee

1:00 PM Joint Legislative Administrative Procedure Oversight Committee

1:00 PM Joint Legislative Commission on Energy Policy

Wednesday, March 8, 2018

9:00 AM Joint Legislative Oversight Committee on Information Technology

9:00 AM Joint Legislative Transportation Oversight Committee

1:00 PM Joint Legislative Economic Development and Global Engagement Oversight Committee