While the dominant theme this past session was addressing our financial challenges, the General Assembly still had many important policy areas to consider.
One of them was state’s mental health system, which has been in disorder for a number of years. During the 2009 session, we worked with the governor to bring stability to the system and build on gains we made in recent years.
To address the budget shortfall in our mental health, developmental disabilities and substance abuse programs, we concentrated on finding efficiencies, moving to more effective services and making small but crucially important investments. The cuts will mean an undeniable reduction in services, but as problems emerge, we are working closely with the Department of Health and Human Services to adjust and to implement improved approaches we may not have otherwise identified.
I have included information about these important changes below.
If you have questions or concerns, I hope that you will contact me. I’m pleased to do what I can to help any of my constituents. Thank you as always for your interest in the work of the General Assembly and state government and thank you for your support.
This year’s budget appropriated $12 million for additional local inpatient beds for the mentally ill to treat people closer to their homes and relieve state hospitals. Last session we funded more than 100 local inpatient beds across the state and we are already seeing the positive effects of reduced admission rates at our state hospitals. Access to local crisis services and local inpatient beds will help us build our local provider networks.
We now require all provider agencies to deliver a continuum of services rather than only one service. This change is expected to save money and improve services. We have found that comprehensive providers allow consumers more stability as they step down from intensive services to maintenance services. This move will eliminate the providers who provide only one service and are reluctant to refer a consumer to another, more appropriate provider who delivers lower or higher level of services.
State facilities that provide mental health, developmental disabilities, and substance abuse services are now required to disclose certain information about death reports, facility police reports, and incident reports under a new state law (S.B. 799 — S.L. 2009-299). The intent of the legislation is to improve transparency.
More local mental health agencies are required to report twice a year how they are spending money under a new state law (H.B. 672 — S.L. 2009-191). The law requires Local Management Entities (LMEs) that use single stream funding to issue a public report on their use of service dollars and receive public comment during a regularly scheduled board of directors meeting. The intent of the legislation is to require more transparency and accountability for state-funded mental health providers.
A new state law clarifies the responsibility of payment of witness fees and guardian ad litem fees in incompetency proceedings (H.B. 506 — S.L. 2009-387). The legislation also authorizes the appointment of a guardian ad litem for a person who is adjudicated incompetent, provides for appointment of counsel for an indigent person in certain proceedings, provides for representation for the Department of Correction and appointment of counsel for offenders in satellite-based monitoring proceedings, and provides for appointment of counsel by the Office of Indigent Services in capital cases.
A new state law clarifies that a Silver Alert may be issued for a person of any age (H.B. 1129 – S.L. 2009-143). The Silver Alert System is a statewide system used to notify people about missing persons believed to be suffering from cognitive impairments.
A new state law directs Division of Health Service Regulation within the Department of Health and Human Services (DHHS) to establish a pilot program to study alternative staffing requirements for facilities that use electronic supervision devices (S.B. 884 — S.L. 2009-490). The law directs the Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services to adopt rules establishing acceptable electronic supervision standards and personnel requirements at facilities for children and adolescents who have a primary diagnosis of mental illness and/or emotional disturbance.
A new state law provides that if inpatient treatment is warranted and a 24-hour facility is not immediately available or appropriate, the a person who is being involuntarily committed for mental treatment may be detained at the site of the first examination. The law also provides a process for required release after seven days (H.B. 243 — S.L. 2009-340). In addition, the law expands the Involuntary Commitment Pilot program to allow a licensed clinical social worker, a master’s level psychiatric nurse, or a Master’s level certified clinical addictions specialist to conduct the initial (firstâ€‘level) examinations of individuals.
A new state law requires a physician or eligible psychologist to contact the Local Management Entity (LME) when a respondent has been scheduled for an appointment with an outpatient treatment center (H.B. 1189 — S.L. 2009-315). The act also allows first examinations for involuntary commitment for mental illness to be conducted by telemedicine.
A new state law establishes a statewide data collection system that reflects how many people with developmental disabilities are currently waiting for services (H.B. 673 — S.L. 2009-186). This list will provide the data needed to effectively serve people with developmental disabilities. The law also permits the Department of Health and Human Services to ensure that state-funded developmental disability services are authorized on an annual or semi-annual basis depending on the services, and will also give direction to the department to develop developmental disability service definitions that allow for funding of a person-centered plan rather than funding each service within a plan separately.
A new state law known as “People First” directs legislative drafting offices and state agencies to use respectful references to people with disabilities in the preparation of legislation and rules (S.B. 208 — S.L. 2009-264). More specifically, the law directs the Legislative Services Office to incorporate into its training of legislative drafters the preference to avoid language that implies that a person as a whole is disabled, that equates a person with his or her condition, or that may be derogatory or demeaning.
A new state law amends the state purchase and contract laws to exempt group purchases made by developmental centers, neuromedical treatment centers, and alcohol and drug abuse treatment centers from a competitive bidding purchasing program (H.B. 1088 — S.L. 2009-184).
The Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services will be directed to adopt rules providing for the licensure and accreditation of residential treatment facilities for persons with traumatic brain injury (TBI) under a new state law (H.B. 1309 — S.L. 2009-361).
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Please invite me to attend your county, city, community or civic, etc. meetings or events.
As I’ve said many times before, I hope you will continue to let me know how you feel about the issues that are being debated by the North Carolina Legislature and the challenges you and your family are facing each day.
By working together, we can make Northampton, Vance and Warren Counties and all regions of North Carolina a better place to live, work and raise a family.
Please remember that you can use the General Assembly’s website to look up bills, view lawmaker biographies and access other information. The site also contains detailed information about the state budget and legislative schedules.