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House | June 23, 2015 | Chamber | House Session

Full MP3 Audio File

The house will come to order, members will take their seats, visitors will retire from the chamber. The sergeant at arms will close the doors. Members and visitors are asked to please silence all electronic devices, today's prayer will be offered by Representative Rena Turner, we'd ask all members and our guest in the gallery to please stand for the prayer and remain standing for the pledge of allegiance. Representative Turner. Thank you Mr. Speaker, would you pray with me please. Father today I pray for our general assembly, and other government and community leaders throughout our towns, cities, states and nation. Give us wisdom in every decision to help us to think clearly, grant us discernment and common sense so we'll be strong and effective leaders. Help us lead and govern with integrity. And may our integrity guide us, and keep us on track. Direct our states according to your word for our decisions have a great impact on many lives. Be our defender and protector and help us always be on guard. Help us to be strong and courageous standing firm in our faith and influencing others for your kingdom encourage and strengthen us giving us the wisdom we need. Help us to have courage and faith in you no matter what we are facing day-to-day we give you this day and thank you for your gifts. May we bring glory and honor to you. For I ask this in the name of my savior in Jesus name. Amen. Allegiance to the flag of the United States of America and to the republic of which it stands one nation under God indivisible, with liberty and justice for all. The gentleman from [xx] Representative Lewis is recognized for a motion. Mr. Speaker, the journal for June 22nd has been examined and found to be correct I move it to stand approved as written. Representative Lewis moves that the journal for June 22 be approved as written those in favor will say aye, Aye! Those oppose no the ayes have it the journal is approved as written. Members our motion of Representative Yarborough of Parson and Granville Counties, the Chair is happy to extend the courtesies to the gallery to daughter, Kimmy Yarborough who of course is Larry Yarborough's wife and her parents Mr and Mrs. Ruffin Woody. Would you all please stand so that we can welcome you with us today. Thank you for being with us. Messages from the senate the clerk will read. House bill 97, 2015 appropriations act. Calendar and without objection, today's calendar so ordered. Is the appropriations act, it will probably be a non concurrence I would suspect, but I have been surprised before. We'll hold our objection on that assurance Mr Speaker. The bill is added to today's calendar, the Chair does not see the nurse of the day with us today, so we'll come back to that. For what purpose does the gentleman from Pearson representative Yarborough rise? For a moment of personal privilege. The gentleman is recognized to speak to a point of personal privilege. The house will come to order. June 23rd, 1990 we had a formal ceremony that marked the folk on the road that led me to be here today. I was in Cape Catawba, Florida working in a really cool job, refurbishing solid rocket boosters, attaching them to the space shuttle and setting them off into space. I gave that up to move to North Carolina and marry my college sweetheart. I got a wonderful mother and father that I love very much, and 25 years later, three children, many ups, one down. I find myself again in a really cool job working with some really great people. The Lord has truly blessed and I am grateful to be spending this milestone with you, thank you. For what purpose does the gentleman from Ashe Representative Jordan rise? Ask the gentleman a question. Does the gentleman from Pearson

yield to a question from the gentleman from Ashe? He does not yield. Inquiry of the Chair. Gentleman may state his inquiry. Does it mean that we have a real life rocket scientist among us? We do, we actually have a NASA Rocket Scientist Engineer who serves in the house with us, so that's Representative Yarborough again we're talking about. Members on the motion of all other members of the house, the Chair is happy to extend the courtesies of the gallery to the teachers, teacher assistants and education support professors and administrators who are here with us visiting from all across the state of North Carolina, we want to thank you all for all you do and we would ask that you stand so that we could welcome you for and thank you for being with us today, thank you for being here. Members with respect to your calendar today the Chair is going to direct that House bill 874 be removed from the calendar and sent to the committee on Judiciary two, this is after requesting the bill sponsor bill is therefore sent to judiciary two. Calendar senator 284 the clerk will read. Senator Hudson senate bill 284, a bill that entitles [xx] provision on the authority granted to counties and cities, this special assessment to address critical infrastructure needs, the general assembly of North Carolina enacts. Further discussion, further debate if not the question for the house is the passing of the senate bill 284 on it's third reading. Those in favor to vote aye, those opposed will vote no the clerk will open the vote. Do the following members wish to record, Representatives Floyd, Queen, Pendleton, Rayne Brown and Daughtry, do these members wish to record on this vote. The clerk will lock the machine and record the vote 101 having voted in the affirmative and none in the negative. Senate bill 284 passes its third reading and will be returned to the senate for concurrence with the house amendment. House bill 372, the Clerk will read. Representatives Dollar, Lambeth, Rayne Brown and Jones, House bill 372 ability to be entitled and act to modernize and stabilize North Carolina's Medicaid program through providing capitalized health plan, the general assembly of North Carolina Members, the Chair would direct that the Senate bill 284 be sent to the Senate via a special messenger. For what purpose does the gentleman from Forsyth Representative Lambeth rise? To debate the bill. The gentleman has the floor to debate the bill. Thank you Mr. Speaker. Ladies and gentlemen. Just a moment Representative Lambeth, the house will come to order. Ladies and gentlemen, the Medicaid is the second largest expenditure in the state budget, accounting for 17.5% of the general fund. It is a government run health insurance program for low income individuals and for individuals with limited resources. The federal government pays two thirds of the bill while the state pays one third. Medicaid is one of our country's largest social welfare program insuring more than 60 million people, it covers naturally more people than medicare and more people than any private health insurer. Medicaid and Medicare were both created by the Social Security Amendments in 1965 as a part of the Great Society Program. July marks the 50th anniversary of it's resistance. Due to the low income and needy criteria the vast majority of persons covered are children, the aged, blind and other persons with disabilities. Each state administers its own Medicaid program following federal guidelines with federal oversight from the centers from Medicare and Medicaid. Any change made to a state's program requires federal approval. In North Carolina federal funding is approximately $2 for every $1 contributed by the state. In North Carolina, taxpayers fund $40,000,000 each day or 1.3 billion each month for the approximate 1.8 million North Carolinians covered under this program. Health care in this state and across the country is changing.

No law we can states afford the price tag associated with the growing calls to Medicaid and it's unpredictability when other funding pressures are demanding more resources. Pressures for funding some are basic services like education, and roads are competing with state Medicaid funds. With a few exceptions our current payment system to providers of care generally rewards volume of services, we pay for admission to hospitals, we pay for more services rendered. Generally the more services provided the more Medicaid pays with virtually no focus on preventive care, quality and outcomes. We must change the payment system reflect a change in the culture that has existed for virtually the entire 50 years of its existence. Transforming health care begins by changing the culture with providers of care in patients, implementing a new reimbursement system that rewards value, quality and appropriate access. It places an emphasis on wellness and preventive care for the patient. I recognize both chambers that have been debating Medicaid reform for many years. Most of that debate has focused on the how not the why. Both chambers agree on the reform principles achieve long term budget stability and predictability, ensure balance quality, patient satisfaction and financial measures. Ensure efficient and cost effective administrative system and structures, ensure a system sustainable delivery system and improve health outcomes. It's the how that has stomped us and caused delay after delay in finding a solution. If there were a simple solution to Medicaid transformation, the general assembly would have done it long before now. There is no easy solution to a complex system comprised of many silos of care that functioned somewhat independent of each other. Our current system often lacks coordination there's little correlation between services and payments versus quality and outcomes. Every health care provider, vendor of health care supplies, schools that train our health professionals bring a significant value to our communities. Often they're the economic engine and the largest employers in our communities and contribute substantially to the economy in your community. I'm certain that either you or someone in your family benefits in someway from the strength of a robust provider system in North Carolina. In North Carolina we have some of the country's best doctors, best health care systems, best patient care of any state in the nation. However, we've created a system that needs to be reformed and modernized for decades to come. As we move to reform Medicaid we must do it with a caution to minimize the risk associated with such a major transformation, but as I said when I came down here, we can do this. We have the opportunity to create a North Carolina solution to Medicaid, and leave the nation just as we have done utilizing community care of North Carolina in an interim step, and we're creating a patient centered medical home, and creating a capitated behavior health network across the state. This modernization plan builds on the strengths of all providers in North Carolina. Providers recognize Medicaid must change and evolve, therefore providers representing all industries; physicians, nurses, hospitals, home care, long term care, behavioral health need to come together to offer input and solutions to this problem, and they've done that. They recognize that our current system is just not sustainable. When the state budget deficit is balanced by cutting rates to providers, some having no rate adjustments in over a decade, providers want to add their ideas and support to transform the current system in fear that more of the same rate cuts will occur in the future to balance state budgets if an alternative is not developed. Now our transition is to the key aspects of this Medicaid modernization plan. Provider lane entities or PLEs as we're referring to them in which the payment is based on a full risk capitated fee to manage and coordinate the care for at least 90% of the Medicaid recipients in all 100 counties. The transformation will occur over a period of up to five years which includes HHS preparation and successfully obtaining a federal waiver from CMS that allows North Carolina to implement this plan. Once fully implemented the state retains the budgetary risks of enrolment growth and mix only, provider lane entities will be responsible for all administrative functions including claims processing, appeals, patient care and case management which was significantly reduced to states current cost of this administrative functions.

Whether there will be multiple PLEs across the state each one must enroll at least 30,000 medicated recipients and meet the solvency requirements set forth by the department of insurance. Management of the Medicaid recipient would be the responsibility of the primary care physicians. Each patient will select or be assigned a primary care physician, it creates an advisory board of experts and healthcare to advise the department on the development of the 1115 waiver application and develop performance goals that would be in each contract. Initially there are several covals that may be faced in into the future. The LMEMCO networks that are already capitated, pharmacy and dental services [xx] as both as well. This bill received a good discussion and support in both the health committee and full appropriations committee. I ask for your support with a yes vote, it is time to resolve the hell and move forward with the North Carolina solution of Medicaid that is the model of transforming quality patient care for the rest of the nation, thank you. For what purpose does the gentleman from Wake, Representative Dollar rise? To debate the bill. The gentleman has the floor to debate the bill. Mr. Speaker, members of the House let me take just a moment to thank Representative Lambeth for all of his hard work over a number of months. He has worked with members in both chambers, he has certainly worked with a wide range of stakeholders and experts as well as the administration to really be the person that has crafted the legislation that you have before you today. Let me just say, and I'll try to be brief because Representative Lambeth really covered it extremely well and that is a couple of important achievements in this bill. The most important is that he did work very diligently as a number of us has have been for a while to bring together stake holders, to hammer out a plan that could be not only agreed to but would really and truly represent transformation of our Medicaid program. It's not simply a matter of saying we want to change how we are paying for Medicaid which really the most important and will mean the most is if we have reform transformation this year that actually changes the intensive's long term so that our focus is on health which rewarded is better health outcomes. This plan also will provide greater budget certainty and again long term cost savings. We believe we achieve that with capitation and again with trying to fundamentally change how we view health care in this state and in this nation. This plan will improve long term health outcomes for our citizens that's critical, and this plan is as Representative Lambeth said builds upon the strengths in our state, we have a number of strengths in our state. We bring in this state physician access for patients that is enviable among a number of the states. We have an award winning, a nationally award winning primary care medical home model senator, United States Senator Burg gave our plan an award a couple of years ago. We have demonstrated strings and stability and a variety of programs that we provide, I will just mention a couple but in the areas of dental, skilled nursing, hospice care, we have some of the best care in the country. According to US News and World report we have hospitals ranked near the top nationally in almost every category of service. We have strengths in our system, and we have been in the process of the last four, five years, really four years reforming our behavioral health system. It's something new and different that was a North Carolina based solution and we have been very successful at that. And this is a North Carolina solution. We build on the outstanding foundation that we have in this state and the strengths of our state. Across this nation state after state has struggled with managing Medicaid. States are challenged to operate a federal healthcare entitlement program, and it is an entitlement program, and that's a challenge for any state and any state budget to wrestle with. And the truth is there is no silver bullet, no one has found the magic thing that suddenly makes all your problems go away. But and North Carolina has seen it's share of challenges we've seen challenges we've seen challenges in our budgets we've seen issues that we've had to address for the last several years. But members I would call your attention to the fact that all of our hard work particularly over the last

four or five years has resulted in a far better system, a far clear picture of where we are. Our per member per month cost is down over the last five years. All the excess spending that was going on around the program has been cleaned up and addressed when it needed to be done. We finally have a new IT system up and running, there are things that have been worked on for a number of years that are in place. We have our new system of coordinating our behavioral health care which is public manage care and that is working and saving us money and satisfying behavioral health consumers around the state. Mr. speaker members of the house, leaders in government health care and advocacy have come together to chart this new course. The new course will end the traditional fee-for-service, payment model and will move us to a system as Representative Lambeth said that pays for value and not the volume of service. A healthcare system that rewards providers for the quality of healthcare outcomes and not simply the quantity of procedures. Again, I want to thank all the provider groups that have come together that are endorsing this plan wide variety. They're endorsing this plan, that have worked together, and that have come together to compromise and commit themselves to making North Carolina's system, healthcare system the best in the nation. We can achieve this, it is for us to do, we have the capability in this state for a North Carolina solution that is unique to our state, and may well be a silver bullet for somebody else down the road I appreciate your changing to the bill and would appreciate your support. For what purpose does the lady from Wake Representative Avila arise? To debate the bill. The lady has the floor to debate the bill. Thank you Mr. Speaker. Ladies and gentlemen the PLE approach is a good plan because it has a lot of benefits. It has the relationship of the providers to their patients, it has the cost effectiveness and control that we are looking in Medicaid. However, the PLE's the ACO's which were the provider led type organizations don't have a long track record, they are just rolling out in a lot of areas, and while that should in enough itself not be the reason to not do it this way, it is the reason we should approach this with caution in saying this is the only way we want to do healthcare in North Carolina. My view is that there are a number of entities out there who deal with the same type of approach of managed care in health, and I feel like that in order to build a stable healthcare system in North Carolina that we have a difference and not just one single way of doing it I think that limits us and exposes us to vulnerability that if this new way of doing things and this approach doesn't work what is plan B, what do we go back to in order to keep our citizens receiving healthcare in a timely efficient and cost effective way. All that aside all the caution and concerns aside, I plan to vote for this bill and the reason I do is simply because it will go to the senate and there will be a lot of discussions, there will be a lot of heads put together, there will be a lot of options argued evaluated and determined, and from that I feel like what we would come up with is probably going to be the best that we can develop for the citizens in North Carolina that we would look at all options, we would evaluate clearly, objectively, and through facts and information what we can give to the citizens of North Carolina to improve their health and to put us on a strong financial footing going forward in North Carolina's healthcare, thank you. For what purpose does the gentleman from Rockingham Representative Jones arise? To debate the bill. The gentleman has the floor to debate the bill. Thank you Mr. Speaker, ladies and gentlemen of the house, basically it goes without saying that Medicaid is a is a huge, huge issue. A large part of our state budget, the lion share of our health and human services budget goes towards Medicaid, and so what we're undertake with this bill, and it's certainly no small task, it's a monumental task. It has been said any time you take the

approach to do something like this there's going to be different opinions of exactly how it should be done. But I think one thing that we probably all agree on is that Medicaid reform is absolutley essential, Medicaid over the past several years has been the budget Pacman if you will eating up the dollars, and those are dollars that are solely needed for other things that are needed in North Carolina. I do want to take the opportunity to commend Representative Lambeth, Representative Dollar and all other members who have extended great time and effort in getting this bill where it is ready to put before us. And has been said and as I think we all know this bill that we passed is not going to be the final plan nor is the senate proposal going to be the final plan. But I think there are a lot of good things in this bill moving forward that as we negotiate that final plan one thing I would like to just point out is that regardless of what we do here at the General Assembly, if you really look at where the rubber meets the road or where the doctors and the staff meet the patients, they're going to have to buy into this plan if it's going to work and as has been said before this is a plan that the health care providers of our state like. I think going forward as we look at that as we look at the way that we can cut Medicaid cost while trying to improve the Medicaid services. This particular plan looks for ways to try to decrease the administrative costs, it includes that options of trying to bring in the providers and keep them working while not trying to balance the budget if you will by cutting those provider rates because if we do that most providers are not going to participate. So I hope that you will vote for this plan today recognizing that is probably not perfect and don't know what is and everybody probably has their opinions of what could be done to improve it. But hope we'll vote for this bill and and we will go forward that we will meet with the Senate and that we will negotiate a very good plan that will take Medicaid program in North Carolina included in a better direction, so I ask you to vote for this bill. For what purpose does the gentleman from Robinson, Representative Graham arise? Thank you Mr. Speaker, and I have a question for Representative Lambeth. Does the gentleman from Forsyth yield to the gentleman from Robinson? Yes sir, I do. He yielsd. Thank you Representative, I just have a question it's on page one it's line 32 and you mentioned this in your presentation 90% of Medicaid recipients to be covered, can you explain what will happen to the other 10%? Good question and I appreciate that question, the other 10% because there will always be some exceptions and do not qualify or there claims are different, they will be paid on the traditional fee for service the current system that we have and that's why we use 90% rather than a higher percentage. We recognize that some Medicaid recipients would be under this plan or in a PLE for a variety of reasons. I want to ask another question but I need to think before I do that but, I'd like to comment on the bill. The gentleman from Robinson has the floor to debate bill. Thank you Mr. Speaker, members I've had some conversations with Representative Dollar about this bill just briefly and I just want to stand in support of this legislation. It's certainly, I think it's moving us in the right direction in terms of quality of care. It's no secret I live in one of the highest Medicaid counties in the state of North Carolina, all we ask for in this bill is for recipients to get good quality of care and I think we're moving in that direction, it's patients standard and the bottom line is making sure that individuals who are Medicaid recipients are in a network of providers that is going to take care of their needs as opposed to putting a bandage on their situation, and we do have situations that does occur. Hospitalizations which could have been prevented. Many situations that could have been turned around in terms of medical needs had they, those patients had type network established to meet their needs. So I think when we're looking at this my interpretation is that as a Medicaid recipient an individual is going to have a primary doctor. That doctor is going to make sure they're getting quality of care, and also doing preventive medicine with those individuals as well.

But if they need a specialist the doctor will be able to in my opinion in this model refer that individual to a PLE within that network and make sure those individuals' needs are being met. And I do agree in the long run this model will hopefully keep cost down, keep our citizens healthy and obviously in the long run we all will win and I certainly thank the bill sponsors for their work on this and I think it's the way we need to go. I understand there's some questions that need to be addressed but I certainly believe at this time in our Medicaid history this is the way we need to be going, and I certainly commend the bill, thank you. For what purpose does the lady from Orange, Representative Insko arise? To debate the bill. The lady has the floor to debate the bill. Thank you Mr. Speaker. Members we should be very proud of our provider community in North Carolina. For the past 30 years they have really led this state and much to the nation toward providing better care for the poor among us. We have among the highest rates of our primary care providers in North Carolina participate in the Medicaid system. Our Medicaid patients are in the mainstream under our current provider-led organizations. And so I'm very supportive of this bill to continue in that track. I'm really very grateful for the work that Representative Lambeth and Representative Dollar has done. I think Representative Lambeth has come to us at a really good time with his enormous experience in hospital and Medicaid care so his expertise I think has helped me be comfortable, especially comfortable with his approach and should have stakeholder groups to have worked with all these stakeholders to come to a consensus position, I'd like to add that the PLE is can still higher than it's care organisation if they choose that's not and then they may well do that some of them may do that. So the manage care organisations maybe participating in this State anywhere on their own and in addition we already have considerable experience with capitated system in our LMEMCO our mental health system is been capitulated for a good number of years. And that population accounts for more than 25% of our Medicaid population it's not insignificant. So our experience with capitation is already well advanced in North Carolina. I'm very grateful also, that the bill sponsors have said lets expect some bumps in the road. I think that would happen if we had a commercial manage care come into support this approach, and I hope that you'll all vote for the bill. Thank you. For what purpose does the lady from Wilson, Representative Farmer Butterfield arise? To speak on the bill Mr Speaker. The lady has the floor to debate the bill. Thank you Mr Speaker, ladies and gentlemen. I've heard about this bill as a member of this body for over four years and that it's a reality. I've had presentations on this bill four times this session and my concern initially were responded to by the sponsors of this bill I want to thank them for sponsoring the bill. I was concerned about community care of North Carolina and how they could tie into this house bill 372 Medicaid reform and that was sufficiently responded to. I was also concerned about safety [xx] providers such as the rural health centers and the public health departments and they can be a part of this reform, so why am I asking that you support house bill 372? First of all, it's patient-doctor provider driven. It's North Carolina home grown so we're talking instate providers and indeed it's cost efficient in terms of administrative cost. It improves budget predictability, patients keep their physicians, physicians maintain control of treatment decisions, it remember what's the value versus volume, removes silos, reduce unnecessary utilization and all stake holders on board, however, is also about the best quality of care short and long-term for patients, thank you. Further discussion further debate. Seeing none the question

before the House is the passage of House committee substitute number to for House bill 372 on its second reading. Those favoring passage will vote Aye, those oppose will vote no, the Clerk will open the vote. The Clerk will lock the machine and record the vote, with 105 voted in the affirmative and 6 in the negative, the House committee substitute for House bill 372 has passed its second reading and will without objection be read a third time. General Assembly of North Carolina enacts. The discussion further debate, seeing none the question before the House is the passage of House committee substitute number two for House bill 372 on its third reading. Those favoring passage will say, aye. Aye. Those opposed will say no. In the opinion of the Chair the ayes have it, and the House committee substitute number two for House bill 372 has passed its third reading and will be sent to the Senate. House bill 556, the clerk will read. Representatives Avila, Lambeth, Hanes and Mayer. House bill 556 a bill to be entitled an act to enact the achieving of better life experience act, General assembly for North Carolina enacts. For what purpose does the lady from Wake, Representative Avila arise? To debate the bill. The lady has the floor to debate the bill. Thank you Mr. speaker, first of all I'm going to explain what the bill does and then I'm going to offer you two very good reasons to vote for it. Back in fall of last year the federal government made a change to the IRS tax code 529 and added another account possibility called 529 able or 529 A. Many of you are familiar with 529 because you recognized it from the college saving plan that's allowed for parents to set up for their children to save for future education expenses and not have to go into debt. This new 529 A plan offers parents an option to put a side money and save for their children who have disabilities. In our current system because of limitations based on benefits the individuals are not allowed to either earn or accumulate much money at all so we literally keep them in poverty, with the 529 plan they can not only save money to pay for the additional expenses that private insurance or their benefits not covered but they can also put in place the funding that's going to be necessary to relieve the minds of the parents who agonize constantly. What will happen to my child when am not here? And that's the first reason why we should vote for this bill. The second reason involves something I learned about a person in studying how this piece of legislation came to take place in congress. Her name is Sarah Wolf and she lives in Moscow, Pennsylvania. She works in a law firm and she volunteers with her local Ark office, and I know many of you in here are familiar with the wonderful work that Ark does here in North Carolina for our citizens with disabilities. She literary lobbied congress for years collecting over 200,000 signatures on a petition to get this legislation passed. We have lots of great activists here in North Carolina that do wonderful things for our citizens with disabilities and needs. The rest of the story from Ms. Wolf however, is the fact that she has down syndrome and she gets SSI benefits, but because of those limitations she is not really able to work and produce at her greatest and highest potential, not able to help pay and save for her future health needs that's the second reason we need to vote for this bill. I really ask for your support, I think you understand what it can do, what freedom it can bring for our citizens here in North Carolina with disabilities because many of them can work and they do want to work and we need to give them that opportunity. Mr. Speaker if you would I'd like to acknowledge my bill sponsors and see if they would be recognized for any comments they would care to make. Further discussion for the debate, if not the question for the house is the passage of House bill 556 on its second reading, those in favor will vote aye, those opposed will vote no, the clerk will open the vote. Representative Hastings, does the gentleman wish to record on this vote?

The clerk will let the machine record the vote, 112 having voted in the affirmative and none in the negative. House bill 556 passes its second reading, and will without objection be read a third time. General Assembly of North Carolina enacts. Further discussion, further debate, if not the question before the House is the passage of House bill 556 on its third reading. Those in favor will say aye, those opposed no, the ayes have it, House bill 556 passes its third reading and will be sent to the Senate. House will [xx] momentarily. House bill 97 the Clerk will read. Representatives Dollar, Elle Johnson, McGrady and Lambeth, House bill 97 the bill to be entitled an act to make base budget appropriations occur operations in state departments institutions and agencies for other purposes general assembly of North Carolina enacts. For what purpose does the gentleman from Wake, Representative Dollar rise? For a motion. The gentleman is recognized for a motion. I move to no, I move to that will shake them up a bit. The gentleman is moving to concur, is that correct? The gentleman moves to not concur in the Senate Committee Substitute. The gentleman has moved to not concur, the gentleman is recognized to debate the motion. Thank you Mr. Speaker, members of the House, this was the size volume we sent. We got it back, I guess twice the size. There are concerns and I'm not going to belabor the point today. There are obviously differences between the approaches, and as always we will work through those differences, the House will be engaged in that process, and we will arrive at a solution that is appropriate for the citizens of North Carolina. I would note just a couple of notes in making the motion. One is that, I do believe we have expressed the concern with respect to the amount of policy placed herein and as we just demonstrated here in the House policies, major policies, should be heard in our committees in both chambers and should be voted on up and down on their merits on the floors of both chambers and considered in that way and the budget should be for truly budgetary items to the fullest extent that we can possibly achieve that. The other item I would just take a moment and mention to you, there has been some discussion over the past several weeks about the amounts of money being spent, I would note that if you go back to 1980 you look at 35 years or so, you've had probably 29 budgets that actually increased spending to one extent or other times obviously were sessions when you were having to lower spending. The average was around 8%, this bill is the House version, this bill was 5% which interestingly was in line with what we did in 2011 which was 5% and is in fact lower on a bi-annual basis than the 2011-2013 budget was. That budget ended up being 7.4% this bi-annual budget the one passed by the House was at 6.3% for the two year bi-annual. Another thing I would point out to you is this always low discussion with respect to taxes and the reference in the finance committee will have plenty to work on in terms of the differences there in revenues and that will obviously need to be worked out before we can move forward with some of the other negotiations but I would point out to the body and to the others that the tax reductions that we have in North Carolina currently in place total sum for these upcoming years, this 2015 is actually over $1.7 billion, $1.7 billion I do include in that the decision that was made not to extend those temporary or those 10 year temporary sales taxes when that was decided back in 2011. What is already in place for the second year the biennium is over 1.9 million in total tax reduction since 2011. If you add

up just what was baked into the house's version of the budget and the first year of the biennium that was $360 million to be increased in 2016 by another $235 million in 2017 by another $235 million and then another $125 million on that in taxes and credits, tax reductions and credits in the second year of the biennium. For those who have been looking for reductions rates were certainly available in the house budget. Again we stand I do believe this will be an easy vote for us today to not concur and we will of course move forward in the process of negotiating with our colleagues in the senate, and I appreciate your vote I'll be happy to answer any questions. Further discussion, further debate? If not, Mr. Speaker. For what purpose does the gentleman from Guilford Representative Blust rise? To ask Representative Dollar a question. Does the gentleman from Wake yield to the gentleman from Guilford? I yield. He yields. Representative Dollar, I could not agree with you more on your assessment of the amount of policy in the senate budget would that be a great idea for us to prescribe that in our rules going forward? Take that under advisement Representative Blust. Representative Blust the gentleman from Wake is not the one who has the authority to answer that question for the gentleman. Further discussion further debate? If not the question for the house is the motion not to conquer with the senate committee substitute to house bill 97 those in favor will vote aye those oppose will vote no the clerk will open the vote. And member the Chair notices there are a couple of no votes out there I want to make sure members understand this a motion not to conquer. The clerk will lock the machine and record the vote 112 having voted in the affirmative and none in the negative the motion not to conquer is adopted the senate will be so notified. Notices and announcements, for what purposes does the gentleman from Durham Representative Hall rise? Be recognized as the same for the statement of protest and decent for Senate article 2, section 18 of North Carolina constitution. The gentleman is recognized for that purpose. Thank you Mr. Speaker, also would make my comments on requesting the privilege for senate rule eight of the house rules and I will be commenting on the integrity of the proceedings here in the house and first of all Mr. Speaker, I appreciate the opportunity to make this statement I think everyone has received a letter as well as the attached petition itself and I'd ask that it be put on the dashboard and be put in the record as prescribed. The gentleman is recognized for that purpose. Thank you Mr. Speaker. While we are in session here we have a special duty and I appreciate the fact that a lot of people have exhibit a great tolerance especially this session to allow other people's view to be heard and be considered. We have a great responsibility to this institution to make sure that happens whenever possible. In many instances we have individuals who can shape the terms of the debate, the tone and the character and I would hope as what has happened in the past we keep the integrity of this house, upper most in our minds as we do our business, for one person can throw us off course and keep us from doing our duty to the State of North Carolina. We had contentious debates in the past we had members who sought to use their opportunity to make comment and we don't feel they were afforded that full opportunity and if that is the case we as a House have failed not just ourselves, this institution and the people of North Carolina. And so going forward not only do we want to register this protest and emphasize how important it is, we understand all the difficulties in bringing all these minds together even when we differ but we have to make that up most effort, we cannot fall short too many people in North Carolina depend upon us, the nation depends upon us as we lead the way in so many different things and we have a responsibility to our constituents. So Mr Speaker, I'd like those comments to be spread upon the record along with the petition of the same and protest to be placed in the record. Thank you. The Chair would direct the same. For what purpose does the lady from Orange Representative Insko rise? Up for announcement.

The lady has for announcement. Thank you, those house democrats that agreed to meet if we adjourn by 3 o'clock we'll meet at the prescribed place in 15 minutes. or what purpose does the gentleman from Henderson Representative Mcgrady rise? For a moment of personal privilege. The gentleman is recognized to speak to a point of personal privilege. Mr. Speaker I arise to note the passing of Danny Sheffer. That may not be a name that's familiar to all of you he was a Fayetteville business man since 1954, city councilman in Fayetteville, but my involvement with Danny was he was a former president of the Sierra Club, I believe the first one from the state of North Carolina. Sierra club resounded by God my name and John Mirror, and there I guess there are 50 some of us, former presidents and outside the State of California, North Carolina actually has surprisingly the most votes but then he was the first. He was involved in all wild drive early conservation campaigns, and civil rights campaigns, he served as president of the club, treasure of the club, secretary of club he was awarded the order of the long lease [xx] numerous awards from the Sierra club both nationally and locally, and for me there's an early mentor so while he was [xx] good friend and constituent I count him also among my friends, and some day that made a very big difference in my life early on, and probably is someway responsible for me being here. And I would ask Mr. speaker if we could, when we adjourn today are adjourn in memory of Danny Scheffer. For what purpose does the, actually before we do that members our nurse of the day has been with us, I want to make sure we introduce her, Crystal Reason Hearl from Williamston ton North Carolina, thank you for being here with us today. For what purpose does the gentleman from Rutherford, Representative Hager rise? For an announcement and a brief point of personal privilege. The gentleman is recognized for both purposes. Thank yo Mr. Speaker, tomorrow the [xx] will caucus in 11 o'clock, 11 A.M in 544 and yesterday Mr. Speaker we missed an important day yesterday if the [xx] was supposed to happen tomorrow the person you're going to be near had a birthday yesterday, that's Representative Chris Millis had a birthday. Happy birthday, Representative Millis, he's not even back here. He already escaped. For what purpose does the gentleman from Cumberland, Representative Glazier rise? For a point of personal privilege Mr. Speaker. The gentleman is recognized to speak to a point of personal privilege. Thank you Mr. Speaker and I want to to follow up Representative McGrady's comments if I may. Danny Schaffer and his family are long time friends of mine, and the fall of this I have actually probably never spoken on the floor in a point of personal privilege about anyone who's passed away in my community, but I really think this person needs to be honored for a moment. Danny was all the things that Representative McGrady said, he also should go given the times that we're in to be noted that he was one of the leading people who helped desegregate the city of Fayetteville and the public schools in Fayetteville and so for all of his incredible work in the environment equally too was his work on civil rights. He is someone who cared incredibly for all human beings, and believed to his core that the care of the planet is the true legacy and gift that we give to the next generation. He was a brilliant man, a principled, a compassionate man who absolutely adored his family, and an incredibly determined man who loved his nation, and his state, and his community and he simply made everyone of us who were around him better people and better friends. Among many people I've been privileged to know he is of the ones who really epitomizes the commandment, love thy neighbor. He would have enjoyed I think the Popes insignical recently, and probably echoed a lot of those sentiments about our duty to our planet but our duty to each other as well our nation and our state. And my community lost a true visionary, a leader and more importantly just a wonderful human being this morning, and I will miss him very, very, deeply and I grieve for his family. Thank you Mr. Speaker.

Thank you. Further notices or announcements? The clerk has an announcement, clerk will read. The House Committee on Health to meet Wednesday June 24th at 10 A.M in room 643. Further notices and announcements, if not the gentleman from Harnett Representative Lewis is recognized for a motion. Mr. Speaker I move that subject to ratification of bills, re-referrals of bills and resolutions, and in memory of Danny Shaffer that the House adjourn to reconvene Wednesday June 24 at 2 o'clock P.M. Representative Lewis moves seconded by Representative McGrady that the House do now adjourn subject to the re-referral of bills and resolutions and the ratification of bills and do so in memory of Danny Shaffer to adjourn to reconvene Wednesday, June 24th at 2 P.M Those in favor will say aye oppose no, the ayes have it, we stand adjourned.