Members of several legislative oversight committees were back in Raleigh this week as the Joint Legislative Oversight Committee on Health and Human Services, Joint Legislative Oversight Committee on Medicaid, Joint Legislative Oversight Committee on Capital Improvements, and the Joint Legislative Oversight Committee on Justice and Public Safety all met throughout the week to hear updates and presentations from various state agencies and stakeholders. While there are no interim committees scheduled to meet next week, the legislature will reconvene for the final skeletal session of the interim where no legislative business will be conducted. The 2024 short session will begin on Wednesday, April 24.

MEDICAID MEETINGS

The Joint Legislative Oversight Committee on Health and Human Services and the Joint Legislative Oversight Committee on Medicaid both met Tuesday to hear from several divisions within the Department of Health and Human Services (DHHS).

Mark Benton, Chief Deputy Secretary for Health, kicked off the pair of meetings with a Medicaid expansion update. As of Tuesday morning’s committee meeting, NC Medicaid has enrolled 416,536 individuals, which represents two-thirds of the original 600,000 North Carolinians that were expected to enroll in the expanded Medicaid program over the next two years. Since expansion went live on December 1, 2023, North Carolina has enrolled, on average, about 1,000 individuals per day, which far outpaces other states that have expanded Medicaid prior to North Carolina.

The committee also heard from Ariel Ford, Director of the Division of Child Development & Early Education (DCDEE), who presented on the division’s efforts to carry out the legislatively required modernization of North Carolina’s star rating system, or Quality Rating and Improvement System (QRIS), for childcare centers throughout the state. DCDEE’s modernization plan identifies three pathways that focus on quality assurance and simplification for both providers and families: Pathway 1 – Program Assessment, Pathway 2 – Classroom and Instructional Quality, and Pathway 3 – Accreditation and Head Start.

The North Carolina Child Care Commission is currently working on the rules needed to implement the QRIS modernization plan. DHHS is working on drafting legislation that would establish the framework for the three pathways to a star rating. Their goal is to immediately implement the new accreditation pathways, direct the Child Care Commission to adopt, amend, and repeal all rules necessary for the implementation of the framework, and extend the facility and education hold harmless until the new rules are adopted.

Kelly Crosbie, Director of the Division of Mental Health, Developmental Disabilities, and Substance Use Services (DMH/DD/SUS) presented to the committee on the investments the division has made using the funds appropriated by the legislature using American Rescue Plan Act Temporary Savings Fund dollars. The division used the funds in five major areas: 1) Medicaid reimbursement rates for behavioral health, 2) crisis system investments, 3) justice system investments, 4) behavioral health workforce funding, and 5) child behavioral health funding.

Director Crosbie detailed the division’s vision for each of the funding areas over the next two years and how the funds will be used to serve North Carolinians across the state. The Medicaid reimbursement rate increases represent about a 20% increase in Medicaid funding for behavioral health. This funding should help in recruiting and retaining additional providers and the crisis system investments focus on ensuring that all North Carolinians have someone to call, someone to respond, and somewhere to go when experiencing a crisis.

The committee concluded the pair of meetings with a Medicaid transformation update and overview of the state’s four local management entities/managed care organizations (LME/MCOs). Jay Ludlam, Deputy Secretary for NC Medicaid, spoke to members about North Carolina’s launch of the Tailored Plans. These plans are enhanced health care option plans that include everything in the Standard Plans, plus services for severe mental health and substance abuse needs, special services for those with intellectual and developmental disabilities and traumatic brain injury needs, services to support well-being such as food and transportation, as well as Tailored Care Management. The Tailored Plans were scheduled to go live in 2023, however, for several reasons, including contracting with providers, the launch date was pushed back to July 1, 2024. Deputy Secretary Ludlam indicated that the NC Medicaid team feels confident that the Tailored Plans are ready for launch after successfully completing their readiness programs.

The CEOs of the state’s four LME/MCOs, Alliance Health, Partners Health Management, Trillium Health Resources, and Vaya Health, provided the committee with a high-level overview of what LME/MCOs do, how they are funded, and the population they will serve. On July 1, when the Tailored Plans go live, the four LME/MCOs will serve over 540,000 Medicaid-eligible individuals, in addition to about 86,000 state or county-funded individuals annually. Further, they will be responsible for managing over $7.3 billion in taxpayer funds. The CEOs concluded their presentation with an overview of each of their individual organizations, highlighting several of their most recent accomplishments in each of their communities.

UPCOMING LEGISLATIVE MEETINGS

WEDNESDAY, APRIL 10

12:00 PM House: Session Convenes
12:00 PM Senate: Session Convenes