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39 <br /> Health & Human Services Goals & Guiding Principles <br /> HH-5: Oppose shifting or cutting money from federal and <br /> state block grants, including TANF, SSBG, CCDBG, HCCBG <br /> and WCH for mandated services. <br /> • Counties have experienced an annual loss of $36 million in <br /> federal welfare reform funds, and the state has eliminated its <br /> $5.4 million annual appropriation in state aid to counties for <br /> social services, although some state aid dollars remain for <br /> county health expenses. <br /> • The state has backfilled state budget cuts in childcare and <br /> other human services programs with federal dollars once <br /> designated for direct county programs. <br /> HH-6: Seek legislation to improve financing and regulatory <br /> issues for the purpose of ensuring the viability of rural hos- <br /> pitals. <br /> • Loss of Medicaid funding, rising health costs, and ongoing <br /> hospital consolidation threaten the viability of rural hospi- <br /> tals. To address this, several states have initiated a study <br /> commission to identify issues facing rural hospitals, such as <br /> Georgia's Rural Hospitalization Stabilization task force. <br /> HH-7: Support Medicaid reimbursement to EMS for mental <br /> health and substance abuse transport to crisis centers. <br /> • While state Medicaid rules allow Medicaid payment for medi- <br /> cally necessary transports to hospitals, it does not permit it <br /> for ambulance transports to mental health crisis centers. <br /> • The 2014-15 state budget authorized a pilot study of Wake <br /> County's mental health transports to determine what legisla- <br /> tive changes and funding sources could support diversion of <br /> mental health crisis patients from emergency rooms to loca- <br /> tions offering more appropriate care. <br /> www.ncacc.org I (919) 715-2893 <br /> 17 <br />