Agenda - 04-04-2023; 8-a - Minutes

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3 1 way to preserve enough of Certificate of Need to keep rural hospitals from going out of business 2 and give enough expansion of practice to nurses so there are more nurses in more places so 3 it's easier to get healthcare. 4 Commissioner Richards asked if anyone is pursuing that middle ground. 5 Senator Meyer said yes. 6 Commissioner Hamilton asked if there is any movement to de-couple these issues. 7 Senator Meyer said that is essentially the House's position. 8 Commissioner Hamilton asked what would change the Senate's position on tying these 9 issues to Medicaid expansion. 10 Senator Meyer said it would take negotiations between House and Senate leadership. 11 Representative Buansi said the Senate passed the Medical Omnibus Bill over the 12 summer that included Medicaid expansion, but House leadership at the time did not want to 13 consider it during that session. 14 Representative Price said Governor Cooper is really pushing for the Medicaid expansion 15 bill by the end of March for the federal bonus. She said there was discussion in the House about 16 how desperately young people need mental health care now and the need for practitioners in 17 every school, or at least accessible to students. 18 Related to youth mental health services, Chair Bedford said she was pleased to hear 19 that the hospital in Butner will convert by July with UNC Hospitals to serve children. However, 20 she noted that it will now be a 2 hour drive for adults in Orange County who need substance use 21 treatment, so fewer will get it. She said we aren't solving the problems, just shifting it to a 22 different population. She said not only are 1/3 of the beds for substance use treatment going 23 away, but there's also the question of who is going to transport the adults if they do get a bed. 24 Chair Bedford said she hopes the legislative delegation supports the Department of 25 Health and Human Service's appeal of the ruling by Judge Baddour about the Olmstead Act 26 because it was going to eliminate all the small group homes. She said the goal is a full 27 continuum of services because some people do need to be in institutions at times in their lives, 28 while others can live in the community without supports. 29 Chair Bedford revisited the following component of the first item on the list on the 30 Board's list of priority legislative issues an: 31 32 • support Medicaid reimbursement to EMS for behavioral health transport to crisis centers; 33 34 She said this would help Orange County financially. 35 36 Chair Bedford also revisited the following component of the first item on the list: 37 38 • reduce the number of people with mental health issues in county detention centers; 39 40 Chair Bedford said the county is working on this. She shared that some Board members 41 are going to learn about a DHHS-funded mental health center in Mecklenburg County and see if 42 Orange County could qualify for something similar. She said the county could build this type of 43 facility but the issue is operating it. She said MCOs are supposed to do this but they don't have 44 the money. She said it's important to keep people with behavioral health issues out of the 45 criminal justice system and overcrowded hospital emergency rooms. She said expanding 46 Medicaid will help many people access the real services that they need. 47 Representative Price said she saw through her work with the National Association of 48 Counties that states with Medicaid expansion have great models and programs with quick 49 handoffs from law enforcement to mental health providers. 50 Commissioner Richards asked if the end of pandemic funding is also part of the 51 discussion. She said the Department of Social Services Director, Nancy Coston, recently spoke