Legislative oversight meetings continued to meet this week, discussing topics including reforming the state’s formula for funding public schools, Medicaid transformation, and emergency and disaster preparedness across the state. Additionally, Special Master Nathan Persily submitted proposed House and Senate maps to the three-judge panel as legislative redistricting continues in federal court.

There will not be a newsletter next Friday, November 24. The team at McGuireWoods Consulting wishes you and your family a Happy Thanksgiving.

Legislative Oversight Committees Meet

Disaster Relief

The House Select Committee on Disaster Relief held their first meeting of the interim on Monday. Director of the Division of Emergency Management Michael Sprayberry updated the committee on ongoing efforts to provide relief to areas of the state that have been impacted by natural disasters. Over $300 million was allocated towards disaster relief through HB 2: Disaster Recovery Act of 2016 and SB 338: Disaster Recovery Act of 2017. Efforts have included:

  • Allocating $435,000 to acquire land outside of a flood plain for the Town of Princeville to redevelop.
  • Awarding a total $8.2 million to ten counties for housing repairs.
  • Allocating $20 million to The Golden L.E.A.F. Foundation for the purpose of providing grants to 23 local governments to construct new-infrastructure.
  • Awarding a total of $5 million to the Rural Economic Development Center, The Carolina Small Business Development Fund and the NC Community Development initiative to make loans to small businesses affected by certain natural disasters.

Education Finance Reform

On Wednesday, the Joint Legislative Task Force on Education Finance Reform met to hear a presentation from Michael Griffith of the Education Commission of the States. Griffith overviewed the components of a high-quality school funding system and noted that, while NC’s current system is equitable, it lacks flexibility for districts and is not adaptable to changes in the educational environment such as making considerations for charter schools and virtual education. Griffith then provided an outline of how other states fund schools. While Griffith included historical funding models, he noted that in the current “generation” of school funding technology allows the state to ensure that resources are following the student to provide a more equitable learning environment. Finally, Griffith presented some considerations for the committee as they continue to look at as they continue the process, including lessons learned from other states.

Emergency Management Oversight

The Joint Legislative Emergency Management Oversight Committee met yesterday to hear presentations from law enforcement agencies and associations from across the state.

First, the committee heard from Special Agent In Charge of the NC State Bureau of Investigations Dirk German on the NC Information Sharing and Analysis Center, a clearinghouse for information related to terrorism and crime that opened in 2006.

The committee then discussed local law enforcement’s role in emergency management with presentations from the NC Sheriffs’ Association and the NC Association of Chiefs of Police who reviewed their policies to respond to both natural and manmade disasters, including mutual aid agreements with other local law enforcement agencies, training the community to speak up when they find something suspicious and efforts to reduce divisiveness during public demonstrations.

Finally, the committee heard presentations from the UNC General Administration and Campbell University on safety and security on college campuses. The UNC System highlighted regular trainings for campus police on all 16 campuses as well as efforts to ensure safety during large events that cause specific challenges. Security on private college campuses is similar to that on UNC campuses, according to Campbell University, who highlighted their unique partnership with the Harnett County Sheriffs’ office.

Health & Human Services Oversight

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

First, Director of the Office of Rural Health Maggie Sauer presented a report on implementing a telemedicine policy for the state. The Department of Health and Human Services (DHHS) believes that telemedicine can improve the health of North Carolinians and that implementation should begin by:

  • Requiring Medicaid Managed Care Organizations to incorporate telemedicine into their payment models.
  • Enacting the recommendations of the NC Office of Broadband infrastructure to ensure access of broadband across the state.

The committee then heard from DHHS Secretary Mandy Cohen on the Department’s strategic plan to address the opioid crisis in NC, her presentation included the following action items:

  • Reducing oversupply of prescription opioids by implementing the STOP Act.
  • Reducing diversion of prescription drugs and flow of illicit drugs.
  • Increasing community awareness and prevention.
  • Making naloxone widely available and link overdose survivors to care by distributing nearly 40,000 units of naloxone.
  • Expanding access to treatment and recovery oriented systems of care.
  • Measuring the state’s impact and revise strategies based on results.

Then, Chief Operating Officer for Technology and Operations Charles Carter provided the committee with an update on the Controlled Substances Reporting System, a statewide reporting system designed to improve the state’s ability to identify people who abuse and misuse prescription drugs classified as Schedule II-V controlled substances. Carter noted that DHHS intends to make improvements to the database including immediate interstate connectivity and Electronic Health Record integration with all NC providers.

Deputy Secretary for Health Services Mark Benton followed with a report on the use of the Dorothea Dix Hospital Property Fund to increase licensed inpatient behavioral beds. In 2016, $20 Million was allocated to the fund from the sale of the Dorothea Dix property from the state to the City of Raleigh. Following a competitive bidding process, all of the allocated funds have been granted:

  • Of the $2 Million allocated for the construction of facility based crisis beds for children and adolescents:
    • $1 Million has been awarded to Family Preservation, which will open in Buncombe County in March 2018.
    • $1 Million has been awarded to KidsPeace, which will open in Wake County in March 2019.
  • Of the $18 Million allocated for the conversion and construction of licensed short-term, inpatient Behavioral Health Beds:
    • $1.4 Million was awarded to create 10 new beds at Southeastern Regional Medical Center in Robeson County.
    • $10 Million was awarded to Duke LifePoint to add 33 beds in Franklin County.
    • $6.5 Million was awarded to Charles A. Cannon, Jr. Memorial Hospital in Avery County to add 27 beds.

Finally, Mark Benton presented an update on the Adult and Pediatric Traumatic Brain Injury Pilot Program. The pilot aims to reduce patient mortality, improve patient recovery and reduce long-term care costs. A Request for Approval to identify a contractor for the pilot program is in the process of development. Benton additionally shared an overview of Traumatic Brain Injury, noting that approximately 2% of the population suffers from TBI.

Additionally, the Joint Legislative Oversight Committee on Health and Human Services, subcommittee on Aging met today and received a presentation from Assistant Secretary for Human Services Michael Beckets and Adult Services Section Chief Joyce Massey-Smith which overviewed the Division of Aging and services available to the aging population. Beckets noted that NC’s aging population is growing, which presents unique healthcare challenges. Massey-Smith reviewed the services made available by the state including adult daycare centers, nutrition services and adult guardianship services.

Justice & Public Safety Oversight

The Joint Legislative Oversight Committee on Justice and Public Safety met yesterday.

First, the committee received a presentation from NC Justice Academy Director Trevor Allen, who provided an overview of the Academy, which was established in 1973 to provide training to state and local law enforcement agents.

The committee then discussed the Statewide Misdemeanant Confinement Program with a presentation from Gary Fife of the NC Sheriffs’ Association (NCSA). The program, which is administrated by NCSA, manages the housing, transportation and medical expenses of state inmates convicted of a misdemeanor crime and sentenced to serve more than 90 days in a county jail.

Finally, Chief Counsel for the ABC Commission Renee Metz presented to the committee on ABC permit revocation. Permit revocation is rare according to Metz, and occurs only in cases where the permit holder makes serious violations including failure to file an audit report or prolific sales to underage customers.

Medicaid & NC Health Choice Oversight

On Wednesday, the Joint Legislative Oversight Committee on Medicaid and NC Health Choice held their second meeting of the interim.

First, Steve Owen of the Fiscal Research Division overviewed Medicaid enrollment, noting that as of October 1, enrollment was 41,748 less than budgeted. Owen also overviewed trends in enrollment including:

  • Continually increasing enrollment in the Family Planning category.
  • Decreased enrollment of children.
  • An overall decrease in enrollment in 26 counties across the state.

Deputy Secretary for Medical Assistance Dave Richard followed with a Medicaid and NC Health Choice financial update , who noted that expenditures continue to be below budget.

Lastly, Dave Richard and DHHS Secretary Mandy Cohen provided the committee with an update on the status of the 1115 waiver. DHHS anticipates submitting an amended 1115 waiver to the Centers for Medicare & Medicaid Services this month and releasing a Request for Proposal for pre-paid health plans (PHPs) procurement in spring 2018. Sec. Cohen noted that DHHS will establish capitation rates and PHPs will compete based on their network of providers and ability to provide adequate services.

Legislative Redistricting Continues

On Tuesday, Special Master Nathan Persily submitted his proposed plans to redraw the state’s legislative maps, giving attorneys on both side of the lawsuit until today to recommend changes. A final plan is due on December 1. Persily was charged to redraw nine House Districts and two Senate Districts. The proposed maps would:

  • Double bunk Reps. Grier Martin and Cynthia Ball, both Democrats, in Wake County House District 49.
  • In Guilford County three districts would be double bunked: Republican Sen. Trudy Wade and Democrat Sen. Gladys Robinson in Senate District 27, Republican Rep. John Blust and Democrat Rep. Pricey Harrison in House District 61, and Republican Rep. Jon Hardister and Democrat Rep. Amos Quick in House District 59.
  • It is difficult to determine, based upon currently available data, whether or not there any incumbents in Mecklenburg County would be double bunked by the changes.

Additionally, because Persilly did not use political data in drawing the maps, it is difficult to determine if the maps would favor one party over another.

A Look Ahead to Next Week

There are no legislative meetings next week.