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January 23, 2017

The Womenís March on Washington

The dramatic impact of the Women's March on Washington gives us hope and reason to stay engaged in and dedicated to the cause of liberty and justice for all. Here in North Carolina, it provided proof that all the hundreds of small to large community groups that are forming will make a difference. This movement reflects an awakening that will carry us forward and through the challenges sure to come. If you arenít involved already, contact me by email at verla.insko@ncleg.net.

Update on potential 2017 NC House and Senate elections

Last year, a federal district court panel ruled North Carolinaís 2011 redistricting maps to be unconstitutional. They ordered new maps to be drawn by March 2017 and a new election in 2017 followed by the regular 2018 elections. That gave Democrats three chances to regain the majority: 2017, 2018 and 2020. Democrats celebrated.

Republicans appealed to the US Supreme Court. In December, Chief Justice Roberts put a hold on the 2017 election and referred the case to the Courtís January 19 meeting when justices would select cases to hear in 2017. If the justices declined to hear the case, the district court ruling would prevail and ensure a 2017 special election. If the judges agreed to hear the case, a 2017 election would be very unlikely.

On January 19, the justices selected two other cases to hear with no reference to the North Carolina case, thus reducing the likelihood of a 2017 election. Democrats are disappointed but still hoping the justices will meet again soon and decline to hear the case. Stay tuned.

Update on NC DHHS, Medicaid, MHDDSA

Want to hear some good news? Meet Mandy Cohen, Governor Cooperís new Secretary of the Department of Health and Human Services (DHHS). Dr. Cohen, an internist, brings valuable years of experience at the Centers for Medicare and Medicaid (CMS), most recently as the Chief Operating Officer and Chief of Staff. Her earlier duties include the CMS Innovation Center, the Affordable Care Act, and the Health Insurance Marketplace. She earned her M.D. at Yale, a Masterís in Public Health at Harvard and her undergraduate degree from Cornell.

Dr. Cohen will provide strong, informed support of Governor Cooperís goal to expand Medicaid as well as sound advice on the Medicaid Reform waiver now under consideration at CMS. In addition, and of special interest to me, she will be able to address the long-standing crisis in our mental health system, most of which is Medicaid funded.

Two issues in our public mental health agencies are: how to consolidate the seven LME/MCOs into fewer, more viable agencies and how to integrate behavioral and physical health without losing our expertise in delivering Medicaid services to the hard-to-serve disabled population.

Another issue is the recent motion filed by the US Department of Justice to enforce the 2012 agreement with the State to move the mentally ill out of adult care homes and into appropriate community-based housing.

North Carolina has long been in violation of the Americans with Disabilities Act by segregating mentally ill adults in adult care homes. A 1999 US Supreme Court ruling made it clear that housing a disable person in an institutional setting is a violation of their constitutional rights - if they can live in the community with the same level of support.

Moving people with mental illness into community housing and jobs is difficult but not the major problem. Our failure is in not providing the treatment services needed to keep them stable, so they rotate in and out of adult care homes. Itís like hospitalizing a diabetic person to stabilize their blood sugar levels and releasing them without access to insulin.

The shortage of community services started in 2001 when the state started closing state hospital beds with a promise that the money saved would be transferred to community services. We didn't keep our word. Instead, we diverted the funds to pay debt service on three new state mental health facilities. Since then, our mentally ill have ended up in emergency departments, in our prisons and in adult care homes. The shortage of effective community based services also affects people with intellectual and developmental disabilities and substance addiction.

Governor Cooper and his staff are committed to finding solutions that work for all three of these groups. I look forward to working with him and Dr. Cohen and others to finally addressing this long-standing failure.

As always, thank you for your support of my work in Raleigh as your representative. Please let me know of your position on issues, your suggestions for legislation and your requests for help.

Verla Insko

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Verla Insko, NC House · 300 N. Salisbury Street, Room 502 LOB · Raleigh, NC 27603-5925 ·
Phone (919) 733-7208 · Mobile (919) 618-9889 · E-mail verla.insko@gmail.com or verla.insko@ncleg.net