Minutes-02-27-2023-Legislative Breakfast

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4 Representative Price said she saw through her work with the National Association of Counties that states with Medicaid expansion have great models and programs with quick handoffs from law enforcement to mental health providers. Commissioner Richards asked if the end of pandemic funding is also part of the discussion. She said the Department of Social Services Director, Nancy Coston, recently spoke to the Board and shared that people who receive healthcare through the additional pandemic- related benefits will fall off care before Medicaid expansion is in place and we may lose contact with them. Senator Meyer said Governor Cooper brings up this issue every time he talks about Medicaid expansion. Representative Buansi said he's on the Housing Standing Committee for Appropriations for Health and Human Services and they received a presentation from the Deputy Secretary of DHHS last week talking about that very issue, as well as how the State will have to make up the gap in funding from lost pandemic benefits. Commissioner Richards asked if State agencies are ready to handle Medicaid expansion when passed. Senator Meyer, Representative Buansi, and Representative Price all said yes. Chair Bedford said the Board received a letter from DHHS saying the State will cover the administrative costs to the county for Medicaid expansion. She said she's glad DHHS is trying to be proactive so counties won't be left with the cost. She said she is grateful for that support. Chair Bedford revisited the following components of the first item on the list: • Increase compensation for nurses and direct support staff funded by innovation waivers and other Medicaid sources. She said while the General Assembly did increase the pay for direct care staff last year, it's still insufficient. She said with an aging population, the shortage will only get bigger. Commissioner Hamilton said the Board heard that the State is not training Adult Care Home and Nursing Home Community Advisory Committee applicants to go into these facilities. She said this is crucial work and there are people willing to volunteer, but they have to be trained. Chair Bedford said she plans to work on this issue as well and may need help from the legislators. Representative Price said they have contacts at the Governor's Office that can assist if needed. Commissioner Richards said she wanted to make the legislators aware that the plan for mental health supports starts at age 4, and there really is a need for it at this age. She said the Board is particularly interested in anything that supports mental health services in early childhood and for children. Senator Meyer said there's discussion across the General Assembly this year about child and adolescent mental health. He said there is also discussion about increasing funding for early childhood care and rate of pay for early childhood care. He said there's crossover in the labor market of people who work in adult care and early childhood care, so if there's funding towards this effort the market dynamics may raise rates for adult care workers too. He said there is also a broad realization that the vacancies in state agencies are due to pay not keeping up with the private sector, so there could be significant increases in state agency pay as well, which could help pay rates in all of these fields.