Minutes 03-21-2024 - Legislative Breakfast

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2 • Increase innovation waiver slots more aggressively to meet the Olmstead Act requirements; • Increase compensation for mental health providers, psychiatrists, nurses, social workers, and direct support staff funded by innovation waivers and other Medicaid sources; and • Support both House Bill 563 and related amendments that: • Provide additional regulation on hemp-derived products such as Cannabidiol (CBD), and prohibiting those designed to resemble well-known candy and other snack food products; • Raise the legal age to purchase and use hemp-derived products to 21; and • Incorporate a ban on the flavoring of vape products. Chair Bedford noted that the legislature increased pay for direct care workers. Senator Graig Meyer said there won't be a budget surplus like in past years due to tax cuts. He said he doesn't anticipate an major health care legislation to pass because everyone is waiting to see what happens with Medicaid expansion. He said expansion has been largely successful. He said there is a lot of work being done by NCDHHS and providers to make sure the new system works well and people get signed up. He said the new director at NCDHHS, Kelly Crosby, is doing a fantastic job of trying to figure out how to improve systems. He said one thing he appreciates is that she has been drawing heavily from expertise here in Orange County from the University and other providers. He said innovations waivers are the largest outstanding need dollar-wise, and there won't be money for that this year. He said the other thing being talked about without a real solution is a plan for increasing the number of providers. He said there will need to be a multi-year plan. Commissioner Fowler asked what he views as the answer to increasing the number of providers. Senator Meyer said he is a fan of incentivizing graduate programs. Representative Renee Price said there is more focus on mental health in the House. She said tianeptine is causing concern right now because it is right next to candy, etc. in the stores. She said the House is looking at regulating vape and hemp products, among others. She said related to mental health, the House has looked more at regulations vs. more providers. Commissioner Hamilton said she recently toured Freedom House and one of the things they talked about is increased pay for direct care workers who are there to support clients. Chair Bedford said the legislature did increase direct care workers' salaries, but it's taking a while to go into effect. Commissioner Hamilton said the pay is still low. She said it's important to keep all people in the mental health field in mind during these discussions. Representative Price said the number of people seeking services at Freedom House is rising and it will be difficult to meet all the needs. She said the House has recently been talking about semi-independent or independent living for folks with disabilities. Chair Bedford said there have been stories recently about people who have moved to these types of facilities, but because of the lack of direct care workers, have had to move back with family. Representative Price said she wonders what the number of providers will be like if laws continue to be more restrictive. Commissioner Hamilton said in addition to waiting to see how Medicaid Expansion goes, the other big thing is the Tailored Plan roll out in July. She said she hopes to see the expected benefits of integrated care actually play out. Senator Meyer said NCDHHS is working hard to anticipate some of the pain points before the Tailored Plan is rolled out. For example, he said there is an inadequate system of care for people with chronic schizophrenia, so they are focusing on how to bolster that system