Minutes-02-27-2023-Legislative Breakfast

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3 Senator Meyer said it varies state by state. He said his take is that there are probably other pathways the state could take where everyone comes out fine. He said he thinks there is a way to preserve enough of Certificate of Need to keep rural hospitals from going out of business and give enough expansion of practice to nurses so there are more nurses in more places so it's easier to get healthcare. Commissioner Richards asked if anyone is pursuing that middle ground. Senator Meyer said yes. Commissioner Hamilton asked if there is any movement to de-couple these issues. Senator Meyer said that is essentially the House's position. Commissioner Hamilton asked what would change the Senate's position on tying these issues to Medicaid expansion. Senator Meyer said it would take negotiations between House and Senate leadership. Representative Buansi said the Senate passed the Medical Omnibus Bill over the summer that included Medicaid expansion, but House leadership at the time did not want to consider it during that session. Representative Price said Governor Cooper is really pushing for the Medicaid expansion bill by the end of March for the federal bonus. She said there was discussion in the House about how desperately young people need mental health care now and the need for practitioners in every school, or at least accessible to students. Related to youth mental health services, Chair Bedford said she was pleased to hear that the hospital in Butner will convert by July with UNC Hospitals to serve children. However, she noted that it will now be a 2 hour drive for adults in Orange County who need substance use treatment, so fewer will get it. She said we aren't solving the problems, just shifting it to a different population. She said not only are 1/3 of the beds for substance use treatment going away, but there's also the question of who is going to transport the adults if they do get a bed. Chair Bedford said she hopes the legislative delegation supports the Department of Health and Human Service's appeal of the ruling by Judge Baddour about the Olmstead Act because it was going to eliminate all the small group homes. She said the goal is a full continuum of services because some people do need to be in institutions at times in their lives, while others can live in the community without supports. Chair Bedford revisited the following component of the first item on the list on the Board's list of priority legislative issues an: • support Medicaid reimbursement to EMS for behavioral health transport to crisis centers; She said this would help Orange County financially. Chair Bedford also revisited the following component of the first item on the list: • reduce the number of people with mental health issues in county detention centers; Chair Bedford said the county is working on this. She shared that some Board members are going to learn about a DHHS-funded mental health center in Mecklenburg County and see if Orange County could qualify for something similar. She said the county could build this type of facility but the issue is operating it. She said MCOs are supposed to do this but they don't have the money. She said it's important to keep people with behavioral health issues out of the criminal justice system and overcrowded hospital emergency rooms. She said expanding Medicaid will help many people access the real services that they need.