The Raleigh Report
From the Office of Cullie Tarleton
April 28, 2008
Health care issues are extremely important concerns for North Carolinians. We all want our families and loved ones to be healthy and strong. As government officials, it is our job to help make sure you have the options and care you need. Legislators serve on several interim committees focused on health care issues. These committees range in scope from public health service to licensing midwives.
Joint Study Committee on Autism Spectrum Disorder and Public Safety
The Joint Committee on Autism Spectrum Disorder and Public Safety studies ways to better train and educate public servants to deal with autism-specific situations. The committee focuses on educating first responder units, public safety personnel, judges, magistrates, district attorneys, and other related organizations.
Recently the committee has discussed lowering the age for the Silver Alert System to include autistic children who may be excluded from the Amber Alert System. The Silver Alert System in the North Carolina Center for Missing Persons disseminates information about missing persons with dementia or some other cognitive impairment. This system will work in cooperation with broadcasters and the Department of Transportation. A new law (HB 38) expands the number of people who can request the alert. Caretakers at a care facility are now authorized to request the alert.
April is Autism month. I recently had the opportunity to attend a meeting of the local Autism Society.
Joint Legislative Health Care Oversight Committee
The Joint Legislative Health Care Oversight Committee studies the delivery, availability and cost of health care in North Carolina. The committee met last week and discussed healthcare access.
Committee members heard presentations from representatives of The Cecil G. Sheps Center for Health Services Research, the North Carolina Retail Merchants Association, the North Carolina Healthcare Information and Communications Alliance and the Association of Community Pharmacists.
The committee discussed using other providers of healthcare such as clinics in retail stores, workforce development issues, and ways technology can improve access to health care.
Healthcare continues to be a priority for the legislature. I like this “thinking outside the box” as new and different ways to deliver healthcare are discussed.
Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services
The Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services reviews the development, financing, quality of service, and delivery of mental health, developmental disabilities and substance abuse services. The committee discussed the increase in length of hospital stays. In recent years, local management entities (LMEs) received money to develop crisis service plans used to reduce stays in hospitals.
Committee members have reviewed monthly system indicators, a workforce development initiative, and the Mercer Report. Mercer Government Human Services Consulting conducted a five-month study of the state’s LMEs. Overall, seven of the state’s LMEs performed above average, 13 were average, and five were below average. One of Mercer’s major recommendations is that the state maintain the LME structure with less than 20 LMEs.
Piedmont Behavioral Health Care LME (PBH) gave a report on its 1915 b (substance abuse) and c (developmental disabilities) Medicaid Managed Care Waiver. The LME has been able to invest Medicaid savings in other areas. PBH has also been able to manage care, create financial incentives, and develop medical plans appropriate for its surrounding population. Three other LMEs (Guildford, Mecklenburg, and Smokey Mountain) will begin the process for approval of these waivers.
I continue to get Mental Health related questions and inquiries from constituents in the district. I look forward to us hopefully “getting our arms around” the Mental Health crisis that exist in North Carolina.
Public Health Study Commission
The Public Health Study Commission studies whether or not county and district health services meet residents’ needs, workforce and facility needs for each area, and standards for maintaining those facilities. The commission also proposes a funding plan for public health care facilities and studies small counties’ ability to meet core public health functions.
The commission’s finalized report can be found at the Legislative Library or at http://www.ncleg.net/LegLibrary/. The report includes a summary of the commissions’ meetings, recommendations for the General Assembly, and draft legislation.
Select Committee on Licensing Midwives
The Select Committee on Licensing Midwives has been discussing whether or not North Carolina should create a procedure for licensing midwives. Nurse midwives are not certified to perform home births. While Certified Nurse Midwives (CNMs) are certified to do home births, 96 percent of labors done by CNMs are hospital births. The North Carolina Nursing Board oversees CNMs.
Committee members heard presentations from people and groups opposed to licensing mid-wives including the North Carolina Medical Society, the North Carolina OB/GYN Society, and the Brody School of Medicine Department of OB/GYN. Opponents of licensing midwives were concerned about the health of the women and babies, a lack of equipment, and the dangers of complications. Some people simply feel it is important to have a physician monitor the mother and baby’s health.
The committee also heard from groups supporting licensing midwives including representatives from the NC Friends of Midwives. Supporters claim that since home birth is an option in North Carolina, the state should license midwives to protect mothers and babies. There is no way to know how many home births are actually performed in the state without licensure. It also costs less to give birth with a midwife. Supporters note that CNMs undergo significant training and screen heavily so that they don’t take on women that are high risk. If you have strong feelings one way or the other on this issue, I’d like to hear from you.
Notes
We had a press conference last week in Raleigh to announce a new program to assist NC farmers impacted by the drought through a cost-share program. Farmers can recover 75% of the cost of restoring drought-damaged pastureland and providing additional water for livestock and crops. This is made possible by a $6 million grant from the NC Tobacco Trust Fund. There will also be a bill coming from the Agriculture Drought Committee that both Sen. Goss and I serve on calling for an additional $6 million from the legislature. The cost-share program covers restoring pastures, renovating and constructing new farm ponds and drilling and re-drilling new wells. All farmers should have received a letter outlining how to apply. If you did not receive the letter and would like more information, please call me at 828-295-3353 or email culliet@ncleg.net.
The Education Appropriations Committee I serve on has been meeting weekly for pass few weeks as we gear up for the short session. At last weeks meeting, UNC President Erskine Bowles made his budget request presentation. Parents will be please to know that Erskin’s number one priority is Campus safety. I agree with Erskine that it’s important we assure parents across the state that ALL UNC campuses are safe environments for their children.
We also heard from our new Community College President, Scott Ralls. I was very impressed with Scott. Obviously, a good choice.
I received word last week that Speaker Hackney had appointed me to another Study Commission. This one will deal with funding and organization of our NC Zoo. I am a big fan of our wonderful Zoo, located in Asheboro; I served on the Zoological Park Council for 26 years and was Vice Chairman and Chairman of the Building Committee prior to being elected. The Zoo is just a 2 ½ hour drive from the high country. It’s a great family outing.
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