The North Carolina House held a press conference this morning on its $22.9 billion budget plan. The Health and Human Services (HHS) portion makes up more than one-fifth of that total amount for fiscal years 2017-18.

Some notable items in the HHS section are listed below:

NC HealthConnex– NC HealthConnex, the state’s Health Information Exchange (HIE), has been appropriated $4 million in FY 2017-18 and $1 million in Fy 2018-19 for maintenance funding. The HIE is a secure “big data” warehouse in which medical providers and health systems who deliver Medicaid services submit and share patient medical information. The overall mission of the HIE is to use this data as a way to improve population health. Medicaid providers are key to making HIE a success – which is why the government is wielding a big stick to ensure they participate. If Medicaid providers want to get reimbursed by the state, they must submit their patients’ clinical information twice a day to the HIE. These medical providers’ electronic health record systems are required to be “HIE compliant” no later than June 2019. Deadline extensions are permitted, as long as they prove to the government that they are making a concerted effort to properly link their EHR systems with the HIE. The North Carolina Department of Health and Human Services (NC DHHS) also intends to use the HIE as a tool to improve Medicaid’s value for patients, because legislators will be given claims data provided by the HIE that indicates whether a patient’s care is effectively being coordinated, or if a patient is undergoing unnecessary duplicative services.

Certificate of Need (CON)While full CON repeal is nowhere to be found in the House budget, legislators have reached a consensus in which selected hospitals in rural areas of the state will not have to slog through the long and expensive CON process if they decide to add more inpatient behavioral health beds or convert unused acute care beds into behavioral health beds. Under current CON law, hospitals and other medical providers must ask the state permission to expand these beds. This exemption from CON aligns with the Task Force on Mental Health and Substance Abuse’s vision to expedite treatment for psychiatric and substance abuse needs. The House plans to distribute $19 million from the Dorothea Dix Hospital Property Fund to the following medical centers for this project:

  • $4 million to Caldwell/University of North Carolina Health Care
  • $4 million to Cape Fear Valley Medical Center
  • $4 million to Vidant Health
  • $3 million to Good Hope Hospital
  • $2.2 million to Mission Health System, Inc.
  • $1.8 million to Dix Crisis Intervention Center

In determining what regions of the state are in “need” of behavioral health resources, the Department of Health and Human Services chose the top 15 counties where patients have to travel more than 100 miles to access necessary treatment. Ultimately, hospitals and other health care organizations should be able to decide for themselves how to go about providing mental health and substance abuse resources – not the state. Yet eliminating CON review in this case is a small but important victory for patients.

For more background information on Certificate of Need laws and how they harm patient access to health care, read here.