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Action Alert on State Budget and Managed Care
The State Budget:
The Autism Society of North Carolina is hearing that General Assembly Appropriations sub-committees may have their budgets done by this Thursday (4/7).
Their ‘targets’ for spending are significant cuts from this current year’s budget: Education must cut $1.43 billion and Health and Human Services, which includes services and supports for people with autism spectrum disorder and other developmental disabilities, must cut $491 million.
Items of importance to the autism and developmental disability community that are under consideration include cuts to special education and other education services, cuts to Medicaid, and cuts to the Division of Mental Health, Developmental Disabilities and Substance Abuse Services (MH/DD/SAS).
While we do not know what the specific cuts are at this time, we urge you to contact your Legislators and tell them not to cut services for people with Autism Spectrum Disorder (ASD), including special education, Medicaid, and other funds for services and supports. Ask them to take a balanced approach to the budget that includes revenue and investments in these critical areas, especially with the likelihood of better than expected revenue projections for this fiscal year.
Managed Care:
The NC General Assembly and the State Department of Health and Human Services (DHHS) are developing a plan to require all developmental disability services to be managed with mental illness and substance abuse services in a "managed care system." The Autism Society of North Carolina (ASNC), along with almost every other developmental disability related organization, opposes this move.
Services and support for people with developmental disabilities are life-long and do not fit in a model of managed care focused on recovery and relapse prevention. Last year, advocates worked with the DHHS and General Assembly to develop a plan allowing the managed care model to expand to two Local Management Entities (LMEs) if the state would work with advocates and other stakeholders to study the effect of such a system and to review other possibilities. Instead, the DHHS and the LME’s are pushing a plan to allow three LME's to immediately bid to manage over half of the counties in North Carolina. This plan is being touted as a cost saving measure, but there are more effective and efficient methods to manage the developmental disability system, many of which are already in place.
DHHS has issued a Request for Application allowing for statewide expansion of the managed care waiver by 2014. Basically, the focus has become rapid expansion of Managed Care at the expense of positive outcomes for people with developmental disabilities. ASNC is working with advocates and Legislators, asking to be involved in plan development and requesting the opportunity to present options that are best suited to manage the developmental disability system. We need your help now!
Please contact your legislator with this simple message...
- Please do not place the DD system into a managed care system with mental illness and substance abuse services.
- Bring DD advocates, providers, families and consumers to the table to help design a system that works.
- Review proposals concerning the 1915i option and DD system design.
- If legislators ask you for additional information please refer them to ASNC and let them know we will provide information to them and are available for questions.
Not sure who represents you?
Background on Managed Care:
North Carolina has had a pilot Managed Care Waiver for MH/DD/SA in the Piedmont Behavioral Health (PBH) catchment area for 7 years. The Autism Society of North Carolina has opposed the expansion of this waiver for many reasons. Most of our objections relate to the conflict between managed care principles and how supports for people with developmental disabilities should be provided and funded. DD needs are very different from Mental Health and Addictive Disease needs.
Although the PBH model has saved money on the Mental Health and Addiction side, it has not on the DD side and the outcomes for individuals have not shown any significant improvement. The creation of a managed care model for all DD services is a much more radical change in system design than Mental Health Reform and, in fact, is the most significant system change this system has ever undertaken.
Last year, we worked in good faith with the State and the Legislature to slow the process down allowing for limited expansion while other alternatives were explored. Despite this, no new evaluation has taken place nor has there been involvement of developmental disability stakeholders in looking at system design. We are very concerned that current lobbying efforts by LME’s, budget pressures and a recently released white paper on managed care in North Carolina (which does not list any authorship) will distort the plan. This white paper proposes the immediate expansion of three managed care sites that would cover as many as 53 counties.
ASNC believes the developmental disability system should be managed and the State and Legislature should look at other proposals. Alternatives for the DD system should ensure that people with developmental disabilities have access to a continuum of services and supports, services are individualized and person centered, and funding is focused on services not additional administration.
For additional resources please see one of the following pages:
Thanks for your continued support and involvement!
Sincerely,
The Autism Society of North Carolina
505 Oberlin Road, Suite 230
Raleigh, NC 27605-1345
800-442-2762
www.autismsociety-nc.org |