Claim: NH to apply for Medicaid waiver on mental health treatment.
Verdict: SUPPORTS

Retrieved passages:
title: Mental health reform in North Carolina
text: Mental health reform in North Carolina The state of North Carolina is undertaking a comprehensive policy shift on how the government budgets for and manages resources for mental health, developmental disability, and substance abuse services. The 1915 (b)(c) Medicaid Waiver Program was chosen by the North Carolina Department of Health & Human Services, Division of Medical Assistance as a way to control and more accurately budget for the rising costs of Medicaid funded services. The 1915 (b)(c) Waiver Program was initially implemented at one pilot site in 2005 and evaluated for several years. Two expansion sites were then added in

title: Mental health reform in North Carolina
text: although it may delegate the day-to-day operation of the program to another entity. In response to its increasingly difficult budget situation, North Carolina is currently undertaking a statewide policy shift in how it budgets and manages funding for Medicaid programs specific to mental health, developmental disabilities, and substance abuse disorders. North Carolina was originally approved to use both the Section 1915 (b) Managed Care/Freedom of Choice Waiver and the Section 1915 (c) Home and Community-based Services Waiver options in October 2004. The 1915 (b)(c) Waiver Program empowers the state designated public authority "to build partnerships with consumers, providers and community

title: Mental health reform in North Carolina
text: in need of mental health, developmental disability, and substance abuse services. The Social Security Act has been amended many times since its adoption to assist states in managing their Medicaid programs to best meet the needs of the state's eligible residents. One way the Social Security Act does this is by authorizing "multiple waiver and demonstration authorities to allow states flexibility in operating Medicaid programs." Each state's Medicaid Agency must submit for review and approval an application for a Home and Community Based Services (HCBS) waiver, and the State Medicaid Agency has the ultimate responsibility for an HCBS waiver program

title: Mental health reform in North Carolina
text: stakeholders to create a more responsive system of community care." The vision of this policy is "Responsible Change to Achieve Easy Access, Better Quality and Personal Outcomes." The appeal of the 1915 (b)(c) Waiver Program is that annual Medicaid expenditures can be more accurately budgeted and managed based on a formula. Under the Waiver, the State would determine a per member per month amount (known as capitation) to be paid to the public authority designated by the NC Department of Health and Human Services (DHHS) Division of Medical Assistance (DMA), the State's Medicaid Agency. The capitation would be based on

title: Mental health reform in North Carolina
text: cost than fee-for-service program costs for Medicaid eligible population." Specifically, in its December 2011 report, NC DHHS shared that "there is a substantial difference in the average expenditure for care beginning in 2008, with expenditures remaining relatively stable at PBH [Piedmont Behavioral Health, the pilot site for the waiver program], while expenditures soared across the rest of the state." Response to the policy change has not been all positive, though. Vicki Smith, Executive Director of Disability Rights NC, stated that there is a "great deal of pressure on DHHS to quickly convert LMEs to Medicaid Waivers so the General Assembly's

title: Mental health reform in North Carolina
text: a formula that takes into account the historical service costs associated with the different Medicaid eligible groups. In addition to the development of the capitation rate, the 1915 (b)(c) Waiver Program grants rate setting authority to adjust service rates to meet local needs, claims payment to ensure funds are spent in line with service authorizations, a closed network to allow for competition and choice within a stable network, utilization management to provide the right service at the right level, and care management to provide direct support to high cost/high risk customers. The state of North Carolina formulated the 1915 (b)(c)

title: Mental health reform in North Carolina
text: North Carolina established the following minimum requirements to participate in the Waiver Program: The state enlisted the assistance of a consultant group, Mercer Government Human Services Consulting, to assist in creating and evaluating an LME's ability to meet the minimum standards. It should be noted that if an LME cannot meet the minimum standards established, they will be required to merge with another LME. The process began with 23 LMEs across the state, it is anticipated that by the end of the implementation process there will only be 8–10 LMEs left. The State's Strategic Plan for the 1915 (b)(c) Waiver

title: Jan Brewer
text: 204 in 2000. After much debate, the Governor's Medicaid Restoration plan was enacted, taking Federal money through the ACA to expand Medicaid. To serve individuals who have a serious mental illness (SMI), but do not qualify for Medicaid, $39 million was added to the budget for additional services. Arizona ranks fifth nationally in spending on community-based programs and has the fewest residents per capita living in a state psychiatric hospital. Arizona's behavioral health system for Maricopa County individuals with SMI has been overseen by the "Arnold" v. "Sarn" lawsuit for more than thirty years. Brewer and the plaintiffs reached an

title: Mental health reform in North Carolina
text: will include: Mecklenburg Area Mental Health, CenterPoint Human Services, Durham Center, EastPointe, Pathways, and CoastalCare LMEs. Any unassigned LMEs will be assigned at that point in time. Mental health reform in North Carolina The state of North Carolina is undertaking a comprehensive policy shift on how the government budgets for and manages resources for mental health, developmental disability, and substance abuse services. The 1915 (b)(c) Medicaid Waiver Program was chosen by the North Carolina Department of Health & Human Services, Division of Medical Assistance as a way to control and more accurately budget for the rising costs of Medicaid funded

title: Mental health reform in North Carolina
text: not adequately managed and continued to grow at a high rate each year. Starting in 2005, the state established one LME as a pilot Medicaid managed care vendor through the use of the Medicaid 1915 (b)(c) Waiver Program. Piedmont Behavioral Health (PBH) served as the pilot program and serves Cabarrus, Davidson, Rowan, Stanly, and Union counties. In 2008, the General Assembly supported the planned expansion of the pilot program through S.L. 2008-107. Then S.L. 2010-31 was adopted and required the designation of two additional expansion sites. Most recently, S.L. 2011-264 instructed the North Carolina Department of Health and Human Services

title: Chris Sununu
text: during the sub-prime mortgage crisis. In 2011, Sununu led a series of public hearings to review proposals for Managed Medicaid, a program to help New Hampshire Medicaid recipients to coordinate their health care. It also helps Medicaid recipients with chronic diseases like diabetes, asthma, obesity, and mental illness. Through this program, Medicaid recipients have wellness and prevention programs as a part of their Medicaid benefit. In 2014, a 300-page, $292 million amendment to the state's Medicaid program came before the Executive Council only two hours before the scheduled vote. Republicans Joseph Kenney and Sununu urged the governor and other Democrats

title: Mental health reform in North Carolina
text: Mental Health and Western Highlands Network (the LME serving Buncombe, Henderson, Madison, Mitchell, Polk, Rutherford, Transylvania and Yancey counties) were chosen as the two expansion sites for the 1915 (b)(c) Waiver Program in late 2010. Mecklenburg County Area Mental Health was scheduled to come online with the 1915 (b)(c) Waiver in 2011 but had trouble with policy implementation and "paused" their Waiver program in September 2010. In June 2011, the State asked Mecklenburg to reenter the waiver program expansion. Mecklenburg County Area Mental Health is now on track to fully implement the policy in January 2013 in the state's third

title: Mental health reform in North Carolina
text: Waiver Program policy utilizing the input of numerous internal and external stakeholders. The original plan was drafted by the staff of the North Carolina Department of Health & Human Services. An External Advisory Team from within the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (MHDDSAS) provided review and feedback. Additional feedback was sought through the North Carolina Council of Community Programs. The NC Council of Community Programs was incorporated in 1983 and is dedicated to helping area authorities in North Carolina improve their service quality and management effectiveness. The draft plan was then posted on the state's

title: Florida Medicaid waiver
text: things that regular medicaid does not pay for. The HCBS Waiver currently has 28 services and there is a spending cap based on the individuals needs. However, services must be "medically necessary". Individuals that meet the following criteria are eligible to receive services under the Home and Community Based Services Waiver: In 2012 there was a waiting list of over 22,000 people for this waiver. Some of the people on the waiting list receive services from the FSL waiver. The Florida Supported Living Waiver, also called the FSL Waiver or "Little" Waiver is another Florida Medicaid Waiver Program. This Waiver

title: Mental health reform in North Carolina
text: website (www.nc.gov) and distributed via a state Communication Bulletin and an invitation was issued for all stakeholders to provide ideas, suggestions, questions, and feedback. A complaint has been noted by the North Carolina Council on Developmental Disabilities that individuals and families feel that they were not consulted prior to their local LMEs submitting applications to be designated as an expansion site. Staff from the NC Division of MHDDSAS responded to this concern by noting that LMEs had little opportunity for this type of stakeholder engagement given the initial time frame for the waiver amendment and the Request for Applications process

title: Florida Medicaid waiver
text: eliminated. Prior to Medicaid Waiver Programs,{1991} many people who had disabilities were served in nursing homes or institutions. The HCBS and FSL Waivers help people to live in their communities by proving supports and services to people who live in the community. It is believed that it is less expensive for people to receive services in the community, rather than in a nursing home or an institution. Florida Medicaid waiver Florida has several Medicaid Waiver Programs. Medicaid Waiver Programs allow recipients to 'waive' institutionalization and instead choose to direct services to assist them to live in the community. Waiver program

title: Florida Medicaid waiver
text: Florida Medicaid waiver Florida has several Medicaid Waiver Programs. Medicaid Waiver Programs allow recipients to 'waive' institutionalization and instead choose to direct services to assist them to live in the community. Waiver program services may offer additional supports and services than provided by traditional Medicaid. The Home and Community Based Services Waiver, also called the HCBS/DD Waiver or "Big" Waiver, is one of Florida's Medicaid Waiver Programs that assists people who have disabilities. These disabilities include: Cognitive impairments, spina bifida, cerebral palsy, Prader-Willi syndrome, Down syndrome, Phelan-McDermid syndrome, and Autism. The HCBS/DD medicaid waiver program helps cover the cost for

title: Mental health reform in North Carolina
text: (NC DHHS) to proceed with the statewide restructuring of the mental health, developmental disabilities, and substance abuse services system by implementing the 1915 (b)(c) Waiver Program statewide by July 1, 2013. Area authorities, like PBH, were originally designated by the state of North Carolina in 1985 through the NC Mental Health, Developmental Disabilities, Substance Abuse Service Act. The name change to Local Management Entity (LME) took place in 2001 when North Carolina passed the Mental Health System Reform Act. Authority for LMEs is organized under North Carolina General Statute Chapter 122C. LMEs are considered a local political subdivision of the

title: Assertive community treatment
text: person's eligibility for this insurance program, to meet its documentation and claim requirements, or to find supplemental funding for necessary services it will not cover—Medicaid reimbursement has led to a long-overdue expansion of ACT in previously unserved or underserved jurisdictions. Public mental health system planners have attempted to resolve the implementation problems associated with replicating the original Madison approach in sparsely populated rural areas or with low-incidence special populations in urban areas. A related issue for planners is to determine the number of ACT or "ACT-like" programs a particular geographical area needs and can support. Some promising areas for further

title: Mental health reform in North Carolina
text: increase of 9% from 2008." The Centers for Medicare and Medicaid Services report that in 2009 (the last year for which data was available) North Carolina had 1,974,287 enrollees in Medicaid. 1.97 million enrollees equaled 21% of the state's population that year (9,380,884). "Title XIX of the Social Security Act is a federal and state entitlement program that pays for medical assistance for certain individuals and families with low incomes and resources. This program, known as Medicaid, became law in 1965 as a cooperative venture jointly funded by the federal and state governments...to assist states in furnishing medical assistance to