THE RALEIGH REPORT
June 30, 2014
As the 2014 short session winds down, we have 3 big issues unresolved between the House and Senate: the State budget, Medicaid reform and Common Core.
The House Health and Human Services Appropriations Subcommittee will hear another version of the Medicaid bill (H1181) on Wednesday.
Everyone agrees we have to “bend the cost curve” in health care. The question is how to dampen the increases without compromising the quality of care. Better yet, can we slow the increases and improve the quality of care?
I believe we have done that through the provider created Community Care of North Carolina (CCNC) program - a private non-profit that partner with primary care physicians to care of Medicaid patients. Medicaid patients are enrolled in a medical home with a treatment plan; a CCNC provider follows up to makes sure the patient follows the plan and gets healthier.
It’s simple and it works. It costs less to take care of a healthy person than a sick person. The savings come from reducing ER visits, preventive care, early intervention and reducing re-admissions after a hospital inpatient stay.
Although CCNC has strong support among providers and hospitals across the state as well as members of the House, Senate Republicans want to contract with a private sector managed-care company to run the entire program, including the authority to set provider rates and control eligibility requirements.
The capitated funding that goes along with Medicaid managed care would give the Senate the predictable budget it wants; but it eliminate CCNC and the system of care we have developed over the last 20 years.
House leaders have proposed building on the system we have by providing incentives for existing providers to form Accountable Care Organizations (ACOs) to care for a group of Medicaid patients and move gradually to a capitated funding system. We will learn more on Wednesday.
The Budget and the House Spending Plan
This week, the North Carolina House unanimously passed a limited spending plan that, most importantly, included a 5% pay raise for teachers and a raise for state employees.
I was happy to see this because House Democrat played a role in deleting the provision to increase lottery advertising and use over-projected and deceptive lottery money to fund the pay raises. I remain concerned over the heavy reliance on Medicaid revenues that are in controversy as an alternative.
Democrats reminded our Republican colleagues that we need more than a “political Band-Aid” and that they will be held accountable for presenting a balanced budget that truly addresses the teacher pay crisis in North Carolina and is more than an election year gimmick.
As the budget continues to be debated in the House and Senate, I will continue to push for an open and public process, so that questions can be asked and answered, and to ensure that raising teacher pay remains the top priority. Our teachers deserve a real plan that raises teacher pay to the national average so that we can attract and retain the best teachers for our students.
The impasse here is whether to repeal the Common Core standards for public schools and replace them as House Republicans propose or to tweak them at Senate Republicans propose.
Some parents complain that Common Core holds high achieving students back because the teacher spends too much time with struggling students.
The main problem I see with Common Core is the role out. We still don’t have text books based on the new standards or the new teaching modality that goes with Common Core. Teachers are still learning how to teach so that students gain a deeper understanding or basic principles – rather than memorizing and feeding back information from the teacher – and students haven’t adjusted to the change.
Any system change requires and deserves a period of adjustment while the kinks are worked out. Common Core, done right, should allow high achieving students to move ahead with appropriate directions from the teacher. It should also prepare our “average” and struggling students with skills that will make them more employable in the future.
Other Activity This Week
Coal Ash - The Senate passed a coal ash management plan. This bill takes steps in cleaning up the state’s coal ash ponds, but leaves in place the provision that would allow Duke Energy to charge customers for part of the cost incurred for cleaning up and shutting down its 16 coal ash sites across the state. As this bill moves through the House I will continue to work for a solution that is fair to the customer and requires Duke to pay for its mistakes and mismanagement.
Hope4Haley and Friends - The House & Senate passed nearly unanimous legislation that would help children with intractable epilepsy receive the care they need without having to leave North Carolina. This bill is now on the Governor’s desk awaiting his signature.
Educators Urge Action on More than Just Salaries
“For the past six years we’ve been under attack,” said Jessica Benton, a special education teacher at Millbrook Elementary in Raleigh. “We are mandated to teach with new curriculum and asked to do all this with less funding…. They’re not asking us for input, and we are the experts.” Likewise, Hollie Blake, a teaching assistant at Lebanon Road Elementary School in Charlotte, said the lawmakers need to focus on more than teacher pay and cutting the budget. “If they cut the transportation budget, we’ll lose our bus drivers. We’ll have longer routes for kids to get to school,” she said. “If they cut school nurses, it can be really dangerous not to have at least one nurse in every school. “It feels like they’re attacking public schools from all fronts,” she added.
Read more here: http://www.charlotteobserver.com/2014/06/25/5003840/mccrory-tillis-move-education.html#.U6xCApRdWSo#storylink=cpy
Governor Makes Plans in Case Impasse Lasts Beyond Fiscal Year
Leaving the budget for FY2015 in place is an option but it’s a bad option. Medicaid is just one example of why. Spending for Medicaid would be far below what’s needed under the already-approved budget due to the current year Medicaid shortfall as well as the rebase, which is a recalculation of Medicaid costs due to factors such as enrollment growth and inflation. Legislators differ on just how much is needed to address the shortfall and rebase as well as other basic budget estimates. And, Medicaid is surely one of the issues being ironed out behind closed doors.
Read more here: http://pulse.ncpolicywatch.org/2014/06/25/governor-orders-budget-cuts-in-case-budget-standoff-lingers-beyond-end-of-fiscal-year
15 Arrested at Final Moral Monday Protest
Protestors packed the hall on the second floor outside the House and Senate chambers, with the overflow crowd funneling upstairs into the third-floor rotunda. The fifteen arrested were led off the second floor about 30 minutes after the rotunda rally began. Each held a red banner emblazoned in white letters with messages such as "Expand Medicaid.'' "We're small but we can still take you out at the polls!'' shouted Pattie Meegan, who was arrested Monday. She said her husband, who is fighting cancer, needs but doesn't qualify for Medicaid.
Read more here: http://www.sfltimes.com/index.php?option=com_content&task=view&id=16323&Itemid=184
Governor Vetoes Unemployment Bill Over Control of Appointments
The legislation adds to unemployment reforms established in 2013 and would require the unemployed to show they have made at least five contacts with potential employers in one week. The current requirement includes two job searches in a week's time. The bill would also make it mandatory for people to present photo identification within the first four weeks of receiving unemployment benefits and it increases the confidentiality of unemployment records in accordance with federal law. The bill would also make it mandatory for people to present a photo identification within the first four weeks of receiving unemployment benefits.
Read more here: http://insurancenewsnet.com/oarticle/2014/06/25/mccrory-vetoes-unemployment-bill-a-522405.html#.U6w6nZRdWSo
Republican Lawmaker Publicly Compares Homosexuality to Pedophilia; Bestiality
Some lawmakers are still outraged over comments made by Rep. Paul Stam Tuesday, comparing homosexuality with pedophilia. The comments came during a debate between lawmakers over a proposal to ban charter schools from discriminating based on sexual orientation or gender identity. Stam handed out a two-page list of definitions of sexual orientation, comparing it to incest and pedophilia among other things. Rep. Marcus Brandon (D) for Guilford County is openly gay and says Stam’s comments were painful. “It’s hurtful that you would compare me personally to a pedophile,” Brandon said.
Read more here: http://myfox8.com/2014/06/25/outrage-over-nc-rep-stam-comparing-homosexuality-to-pedophilia
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.
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