Mark Botts of the UNC School of Government presents the latest round of legislative changes to North Carolina mental health system reform, and what it means to county governments and commissioners in this workshop held Aug. 22, 2013, during the NCACC's 106th Annual Conference.
3.8 What’s at Stake: Federal Policy Decisions in 2012 and Beyond
Speaker: Liz Schott
The deficit reduction deal and further decisions made by Congress to reduce the federal deficit have made, and will continue to make, a tremendous impact on low-income housing and homeless assistance programs for many years to come. This workshop will cover the important funding decisions of the past months with an outlook on select programs for the upcoming year and beyond. Presenters will discuss ways in which advocates can make an impact at this incredibly important time to preserve and increase funding for key programs.
3.8 What’s at Stake: Federal Policy Decisions in 2012 and Beyond
Speaker: Liz Schott
The deficit reduction deal and further decisions made by Congress to reduce the federal deficit have made, and will continue to make, a tremendous impact on low-income housing and homeless assistance programs for many years to come. This workshop will cover the important funding decisions of the past months with an outlook on select programs for the upcoming year and beyond. Presenters will discuss ways in which advocates can make an impact at this incredibly important time to preserve and increase funding for key programs.
In this webinar, Roberta Newton, manager of the Los Angeles Office of the State Council on Developmental Disabilities speaks about:
> The importance of the Centers for Medicare and Medicaid Services (CMS) and Home & Community Based Services (HCBS) for people with developmental disabilities and their families.
> What changes are coming to HCBS and and how people with developmental disabilities will be affected.
> How to prepare for and participate in the development of new HCBS regulations.
The Accountable Health Communities Model team hosted a webinar to provide an overview of the new funding opportunity and application requirements for Track 1 on Wednesday, September 14, 2016 from 2:00p.m. – 3:00p.m. EDT.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Accountable Health Communities Model team hosted a webinar to provide an overview of the roles of state Medicaid agency partners for Track 1 on Monday, September 12, 2016 from 2:00p.m. – 3:00p.m. EDT.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
This Accountable Health Communities Model webinar was held on Wednesday, February 10, 2016 from 3:00 – 4:00pm EST. The webinar focused on the anticipated role of state Medicaid agencies in the model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
In this webinar, Roberta Newton, manager of the Los Angeles Office of the State Council on Developmental Disabilities speaks about:
> The importance of the Centers for Medicare and Medicaid Services (CMS) and Home & Community Based Services (HCBS) for people with developmental disabilities and their families.
> What changes are coming to HCBS and and how people with developmental disabilities will be affected.
> How to prepare for and participate in the development of new HCBS regulations.
The Accountable Health Communities Model team hosted a webinar to provide an overview of the new funding opportunity and application requirements for Track 1 on Wednesday, September 14, 2016 from 2:00p.m. – 3:00p.m. EDT.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Accountable Health Communities Model team hosted a webinar to provide an overview of the roles of state Medicaid agency partners for Track 1 on Monday, September 12, 2016 from 2:00p.m. – 3:00p.m. EDT.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
This Accountable Health Communities Model webinar was held on Wednesday, February 10, 2016 from 3:00 – 4:00pm EST. The webinar focused on the anticipated role of state Medicaid agencies in the model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Drug Medi-Cal's ODS Waiver: Is Your Organization Ready for the Next Steps?Epstein Becker Green
Webinar presented by Kathryn F. Edgerton (Partner, Nelson Hardiman) and attorney Kevin J. Malone (Epstein Becker Green).
Part of a "first Thursdays" fall webinar series hosted by Behavioral Health Association of Providers, Epstein Becker & Green, P.C., and Nelson Hardiman, LLP.
More info: https://www.ebglaw.com/events/one-in-three-californians-is-a-medi-cal-beneficiary-is-your-organization-ready-for-the-next-steps-in-drug-medi-cals-ods-waiver/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Medicaid: What You Need to Know (CSH and Foothold)Ronan Martin
In our first session, Foothold Technology Director of Client Services, Paul Rossi and Senior Advisor, David Bucciferro, along with Sue Augustus from CSH, will bring us back to basics of all things Medicaid. They will cover topics ranging in commonly used terms, coverage and eligibility and the differences between Medicaid and Medicare. This webinar series is designed for beginners and experts alike. Beginners will walk away with a strong foundation and experts will have the opportunity to contribute to the conversation.
Slideshow presentation from the NC Association of County Commissioners' update at the 2016 City-County Management Association Winter Seminar on Feb. 5.
Arturo Lara produced this report on his interview with Dare County Vice Chair Wally Overman and report on the Board of Commissioners meeting as part of his pre-conference assignment before attending the NCACC's YouthVoice 2015.
Anthony Blandino produced this interview with County Manager Aaron Church, highlights of his tour of the County Administrative Building, and report on the Board of Commissioners meeting as part of his pre-conference assignment before attending the NCACC's YouthVoice 2015.
Kayla Welch presented this scrapbook highlighting her tour of the Chowan County Administrative Building, and what she learned by following her county government in the newspaper.
North Carolina General Assembly Fiscal Analyst Patrick McHugh, Ph.D., discusses economic incentives and related topics during this Dec. 5, 2013, discussion with the NCACC Economic Development Task Force.
Tony Almeida, Sr., advisor to Governor Pat McCrory on Jobs and the Economy, presents an update on the Economic Development Board to the Joint Legislative Economic Development & Global Engagement Oversight Committee on Nov. 7, 2013.
Jim Jarrard, Deputy Director of the N.C. Division of Mental Health/Developmental Disabilities/Substance Abuse Services (MH/DD/SAS), and Leza Wainwright, East Carolina Behavioral Health (ECBH) Executive Director, provide state- and local-level perspectives on the status of Mental Health in North Carolina to the North Carolina Association of County Commissioners (NCACC) Health & Human Services Steering Committee on October 18, 2013.
In this workshop held Aug. 23, 2013, at the 106th Annual Conference of the N.C. Association of County Commissioners, corporate site selector Kate McEnroe discusses how county officials can balance the interests of their county with the realities of achieving visibility and investment success in a crowded global marketplace. McEnroe reviews what potential investors expect while they are researching their options and what they need from county officials “after the sale” to stay committed to being part of the local economy.
NACo Deputy Legislative Director of Health Paul Beddoe discusses what public policy leaders should know and do about the Affordable Care Act during a North Carolina Association of County Commissioners seminar held Oct. 15, 2013, in Orange County, N.C.
Citizens academy program leaders in Cumberland, Guilford and Nash counties discuss challenges, details, differences in programs, and success stories during a workshop held at the 2013 North Carolina Association of County Commissioners' Annual Conference.
NCACC Intergovernmental Relations Director Rebecca Troutman discusses the funding sources for public schools in North Carolina during a workshop held Aug. 23, 2013, at the NCACC's 106th Annual Conference.
Kara Millonzi of the UNC School of Government provides an overview of county funding responsibilities for public schools as part of a workshop held Aug. 23, 2013, at the NCACC's 106th Annual Conference.
David Atkinson, Carteret County Social Services Director, discusses the impact of the Affordable Care Act on North Carolina county departments of social services
Dr. Pam Silberman, President and CEO of the N.C. Institute of Medicine, provides an overview of the Affordable Care Act in North Carolina as part of a NCACC Annual Conference workshop on Aug. 24, 2013.
As part of a 2013 NCACC Annual Conference workshop on the Affordable Care Act, Pitt County Health Director Dr. John Morrow discusses the impact of the Act on North Carolina county public health.
Here is Gabe Whitley's response to my defamation lawsuit for him calling me a rapist and perjurer in court documents.
You have to read it to believe it, but after you read it, you won't believe it. And I included eight examples of defamatory statements/
An astonishing, first-of-its-kind, report by the NYT assessing damage in Ukraine. Even if the war ends tomorrow, in many places there will be nothing to go back to.
‘वोटर्स विल मस्ट प्रीवेल’ (मतदाताओं को जीतना होगा) अभियान द्वारा जारी हेल्पलाइन नंबर, 4 जून को सुबह 7 बजे से दोपहर 12 बजे तक मतगणना प्रक्रिया में कहीं भी किसी भी तरह के उल्लंघन की रिपोर्ट करने के लिए खुला रहेगा।
El Puerto de Algeciras continúa un año más como el más eficiente del continente europeo y vuelve a situarse en el “top ten” mundial, según el informe The Container Port Performance Index 2023 (CPPI), elaborado por el Banco Mundial y la consultora S&P Global.
El informe CPPI utiliza dos enfoques metodológicos diferentes para calcular la clasificación del índice: uno administrativo o técnico y otro estadístico, basado en análisis factorial (FA). Según los autores, esta dualidad pretende asegurar una clasificación que refleje con precisión el rendimiento real del puerto, a la vez que sea estadísticamente sólida. En esta edición del informe CPPI 2023, se han empleado los mismos enfoques metodológicos y se ha aplicado un método de agregación de clasificaciones para combinar los resultados de ambos enfoques y obtener una clasificación agregada.
03062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
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01062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
CLICK:- https://firstindia.co.in/
#First_India_NewsPaper
04062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
CLICK:- https://firstindia.co.in/
#First_India_NewsPaper
3. S.L. 2013-85 (Senate Bill 208)
1. Operations – Enhanced state monitoring
2. Organization – Diminished county role
3. Governance –Diminished county role and
(in some cases) greater professional
involvement
** Immediate Action: Counties must appoint
county commissioner advisory board**
3
5. What Do LME/MCOs Do?
5
2011
23→11 Managed Care Organizations
Managers of service providers and
service money
2001
39→23 Local Management Entities Managers of service providers
1992
42 Area Authorities Service providers
6. What Does an LME Do?
Local management entities are responsible
for the management and oversight of the
public system of MH/DD/SA services at the
community level. An LME shall plan,
develop, implement, and monitor services…
to ensure expected outcomes for consumers
within available resources.
G.S. 122C-115.4
8. Who Pays for Services?
Medicaid
62%
State and
Federal
Block Grant
29%
County
9%
Other
0%
$93 million
CenterPoint Human Services
FY 2012-13 Budgeted Revenues By Source
9. Who Pays for Services?
Medicaid
80%
State/Federal
Block Grant
18%
County
2%
Other
0% $356 million
Cardinal Innovations
FY 2012-13 Budgeted Revenues By Source
10. Medicaid and Mental Health
Services in the U.S.
• Then (1986)
– Medicaid contributed less than
three other payers: state and
local governments, private
health insurance, and patients
• Now
– Medicaid is the largest payer of
mental health services in the
United States, more than any
other private or public source of
funding
12. Medicaid Managed Care
All LMEs must implement the “1915(b)/(c)
Managed Care Waiver” by July 2013
S.L. 2011-264 (H 916)
13. Medicaid “Waiver”
• The federal government waives
particular Medicaid rules to allow a state
to operate Medicaid in a different way
• NC’s waiver allows implementation of a
“managed care” delivery system
intended to contain costs while
improving quality of services
13
14. NC Medicaid: What’s Changed?
• Managing the cost of care
– fee for service → capitation funding
• Managing the quality of care
– freedom of choice → mandatory enrollment
More than 65% of the total U.S. Medicaid
population is served through some type of
managed care arrangement
16. Managing Care
Eligible individual?
Covered service?
Based on clinical assessment?
Medically necessary?
Qualified provider?
Evidence that treatment helps?
Other needed services?
Outcomes over time?
ProviderLME
LME
17. Operational Compliance—2012
If an LME operating the Waiver fails to meet
performance expectations, DHHS must
reassign its Waiver (managed care) functions
to another LME
S.L. 2012-151 (S 191)
18. Operational Compliance—2013
Legislation
• Governed by LME/MCO–DHHS Contract
• DHHS certification every 6 months
– Adequate provision against risk of insolvency
– Timely provider payments
– Adequate exchange of information (billing,
payment, other transaction data) with DHHS
and providers
S.L. 2013-85 (S 208)
18
19. Compliance Failure
• Written notice of noncompliance to LME/MCO
• Reassign contract (Waiver) responsibilities to
another LME/MCO
• Oversee transfer of operations to another
LME/MCO
• Dissolve the noncompliant LME/MCO
• Notify the BOCs of the member counties of
the dissolving LME/MCO
S.L. 2013-85 (S 208)
19
21. Organizational Options—Once
Upon a Time
Counties
choose
• Area authority
• Multicounty area authority
• Single-county area
authority
• County program
• Multicounty program
• Single county program
• Consolidated human
services agency
21
22. Recent Constraints on Agency Type
• “Beginning July 1, 2013, the catchment area
of an area authority or a county program
shall contain a minimum population of at
least 500,000.”
G.S. 122C-115.
• Between July 1, 2012, and July 1, 2014, no
county may withdraw from a multicounty
area authority operating under the
1915(b)(c) Medicaid Waiver.
S.L. 2012-151
22
24. 2013 Legislative Changes
“A county shall provide mental health,
developmental disabilities, and substance
abuse services through an area authority
or county program . . . ” G.S. 122C-115.
S.L. 2013-85 (S 208)
A county may not consolidate MH/DD/SA
functions into a consolidated human
services agency. S.L. 2013-378 (H 399)
24
25. Organizational Options Now
Establish
agency
• Area authority
• Multicounty area authority
• Single-county area
authority
• County program
• Multicounty program
• Single county program
• Consolidated human
services agency
25
26. Establishing an Area Authority
• Two or more BOCCs shall jointly establish an
area authority with approval of the Secretary of
DHHS
G.S. 122C-115
• Area authorities may add one or more additional
counties to their area by agreement of a majority
of the existing member counties upon the
adoption of a resolution . . . by . . . the area
board and the approval of the Secretary.
S.L. 2013-85
26
27. Dissolve or Withdraw from
the Area Authority
• BOCCs jointly may dissolve a multicounty
area authority
• A single BOCC may withdraw its county from
a multicounty area authority and join another
• Requirements:
– Best interest
– Public hearing
– Prior approval of the DHHS Secretary, who must
adopt rules governing conditions, timing, notice
G.S. 122C-115.3 27
29. Appoint the Governing Board
• The boards of county commissioners
within the area shall appoint members
• The counties must approve a plan for
their LME that describes the board
composition, appointments, and selection
process.
G.S. 122C-115.2(b)(2) and -117(8)
29
30. Appoint the Governing Board
• New Requirements—G.S. 122C-
118.1
– 11-21 voting members
– 11 prescribed categories of
representation
– 2 prescribed non-voting members
• Compliance Date—October 1, 2013
30
31. Appoint the Governing Board
• Maximum of 3 terms
• 3-year term
• Staggered terms initially
Compliance Date—October 1, 2013
31
32. S.L. 2013-85 (S 208)
• Retains compliance date of Oct. 1, 2013
• Permits area authority with 1.25 million
population to opt out of compositional
requirements if
– each county adopts a resolution to that effect
and
– written approval granted by DHHS Sec’y
32
33. S.L. 2013-378 (H 399)—Exception
Does not apply to an area authority that,
• before Oct. 1, 2013, is approved or directed to
dissolve, or
• is approved to add counties from a dissolving
area authority
In this case, new entity must meet statutory
requirements within 30 days of eff. date of
merger or by April 1, 2014, whichever is sooner.
33
34. S.L. 2013-85 (S 208)
Requires county commissioner advisory board
for each area authority to
• Meet on a regular basis
• Advise area authority on the delivery of services
Appointment and composition
• One county commissioner from each county
designated by the county’s BOCC
• Each BOCC determines the manner of
designation, term, and conditions of service of its
designee
34