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Senate | April 21, 2015 | Chamber | 20150421_senate_healthcare

Full MP3 Audio File

Ladies and gentlemen please take your seats and we're getting our Committee Meeting started [xx] Ladies and gentlemen please take your seats. we have a few miles to go today before we get out of here we have several Bills in the calender if you will please take your seats, silence all of your wireless devices and we will get started. I'd like first of all to introduce Pages who are with us today Senate Health Care Meeting, Emily and then from Sam and Demly[sp?] please raise up your hands we're gland to have you back in the room she was sponsored by senator Rabin and Madam Ramsolf from Gastonia we are glad to have you with us London and you are sponsored by senator Harrington we you hope that you are enjoying both of you young people are enjoying your week up here and thank you for your service to us today. Also like to introduce Sergeant at Arms Steve McKeen, Mckeen I am sorry and they'll have to apologize for that glad to have both of you gentleman with us today as well we have several bills on the agenda we are going to start off with senate bill 368 there is a PCS is there a motion for consideration of the PCS by senator Hayes all those in favor of consideration of the PCS please say aye all opposed no and the PCS is before you Senator Barm. Thank you Mr. Chairman what this PCS it does it allows the department of defense certified child care facilities to participate in a state subsidized child care program, under section one it provides apparent procedures regarding DOD certified child care facilities which are each [xx] department of health and human services a notice of intent to operate a child care facility in a form determined by the department of Defense. Each facility must file a report to DHHS indicating that it meets the minimum standards for child care facilities as  provided by the department of defense facilities that meet our of this section are exempt from all the requirements of the chapter and DOD certified child care facilities are reimbursed under the North Carolina subsidized child care program under section two it provides the guidelines for the child care subsidises and section three allows the DOD certified child care facilities licensed under the statue to participate in the states subsidized Child Care Program that provides for the purchase of care and Child Care facilities for amount of children in needy families and it provides the funds allocated from the state subsidized program to DOD certified facilities. In my District DOD Child Care facilities we have found some of the high standard and it just allows him to take advantage of some of the programs we have here in the state. That's it. Thank you Senator Bell are there the questions for the members of the committee Senator Wade. At the appropriate time I would like to move for a favorable report We'll hold that up but we'll be back to shortly are there any other questions from members of the committee, hearing none Senator Wayde moves for favorable report on Senate Bill 368 may have a PCS has ever been favourable to on favorable to the original bill, all those in favor say aye, all those oppose say no, congratulations senator Brown you went through the ropes dint you? Next will be senate bill 578 their is a PCS to senate bill 578 is their a motion to except the PCS senator Robinson all those in favor say aye all oppose no the motion caries under PCS's four year senator Barringer. Thank you Mr. Chair this bill comes to us

from the department of health and human services as quest I would like to thank the primary sponsor on the bill senator Tucker and senator Highise[sp?] we also have in the room to answer questions from the department we have Adam Sholler we also have from the Attorney General's office Alexy group who can come forward and ask some questions I would be briefly describe the goals of the bill and if there are any questions we can certainly direct them to those or to staff. This bill was filed in response to DHHS request that legislation be put forward to establish that it's division of child development in early education become the sole agency responsible of investigating allegations of abuse and neglecting child care settings. Currently DCDEE and the local departments of social services share this responsibility in May of 2014 the North Carolina court of appeals held that DCDEE was responsible for substantiating whether child abuse and child neglect occurred in licensed childcare facilities which effectively requires both these DCDEE to make the same, to make legal determinations and DSSS to do the same which further obviates the need for this, for due investigation at Child Care Facility. There is risk under the current situation if the two Agencies decides expanding Government funds in duplicate that their determination may conflict, and which would make it very difficult to be able to provide a safe environment for these children. So the benefits of having just the Department of Health and Human Services, the state agency to be the investigative arm is there will be less confusion, there will be more time for DSS workers to actually spend time working with families and individuals, it will streamline the investigation and increase the accuracy and make it a more efficient process. There'l be more timely closure of cases, and it would further eliminate any duplication of efforts and finally this bill will create a child maltreatment registry containing the names of all caregivers who have been confirmed by DHHS of having now treated children, but please do understand that we've worked out some privacy concerns because an allegation of such a thing could be very catastrophic to a childcare agency and so please note that those would only be listed on this registry once they there has been an affirmative finding that the abuse had actually occurred. I'll be happy to answer questions or actually as I said, we have wonderful folks here that could and serve them even better. Thank you Senator Benken, questions from members of the committee, Senator Robinson Mr. Chair, the appropriate time I'd like to move for a favorable report, but I'd like to ask one other question Senator Barringer, Mr. Chair Will this by anyway diminish the time to get to the specific investigation. Was there some collaboration that helped it to move forward or will this make sure that we have speedy investigations in this cases? Senator Benken. It is been represented to me by the department that this will speed things up because in the past they were getting in each others ways. It was causing all kinds of conflicts and problems, and I've been assured that there is staff available to be able to do this, they are all ready doing it and this will streamline the process so that we can get to the bottom of these allegations as soon as possible. Further questions from members of the committee? Seeing non Senator Robinson move for favorable report as to the PCS unfavorable as to the original bill. All in favor please say I all opposing may say no and Senate bill 578 will go forward. Thank you very much. And has to be re-referred to J2. Senator Benken[sp?] you did a good job, would you come back up are you presenting 235 as well? I beg you pardon. 367, I'm sorry 367 you're recognized. 367 has a PCS as well. Is there a motion to consider the PCS? Senator Robinson moves to consider the P. C. S Senator Barenger you can start and Senator Hise will back clean up. Thank you very much myself Senator Hise and Senator Apodaca bring this bill before you today, this is a very, very exciting and wonderful bill it's called the Able Act and it's the achieving the better life experience Act

which aims to help people with disabilities, parent and guardians plans for their child's future to the creation of 529 savings accounts, similar to other 529 account which are currently used for education savings. The able act provides individuals with disabilities the same type of of flexible saving stores that all other American have to college on savings account, same as accounts and individual retirements accounts. The able act will give families the opportunity to invest for future, the future of their families and the plan for in safe for their child's future. The establishing of this accounts in our state will assist people with disabilities by helping them to find essential expenses for individual including medical in dental care, education, community based support, employment training, training assisted Technologing housing, transportation and education as with existing 529 accounts investments and this accounts can be made by individual, family or friends without fear of losing essesntial federal state federal and state benefits provided through critical safety net programs such as medic aid and supplemental security programms. This important legislation continues state to work on improving the lives and outcomes of people of our families with children's with disability and supporting their family and loved ones and I will now yell to Senator Hise Thank you Senator Berger and Mr Chairman for the opportunity. What, we're trying to achieve in this bill and I just say basically is to allow families that have a child with disabilities to make actual plans for their future and what will happen after they pass on when some else needs security without destroying that individual qualification for their benefits, that's why we're coming here, they simply leave the funds to the they inherited world terms, so that they can have great negative impact on what that individuals qualify for, and means the state ones will put all the funds in the federal government winds up for those funds versus them being used for the care and service. I will say to members on this bill this is going to finance and we are aware that with the managing the 529's being under treasury office, it will be some funds we need to identify to make sure they can adequately fund on this operation we paid for those as we move financiesters, some questions without the entrance was going to be up to do without prome, but they formed out there 529's and so in putting that together we know there would up some cost in state of doing those, and we can figure this is why we're discussing the health policy applications and we will be prepared for the financer preparations as we move into those committee. Senator Harts do you have any question? I just want to make a move for a federal report proposed committee unfavorable to the original Bill, Hold one second will hold on to that, Senator Robinson Thank you Mr. Chair, I think it's a great Bill I do have a question 529s are tax deductable from the parents who make those contributions questions, what we have in this bill the people are have contributions deductable for the payments made by other people as well could for the funds and to these trans-funds for other individual what about for those other individuals who do they qualify for anything? Great. Senator Hason[sp?] This will qualify for the Federal Tax Reduction from the operations [xx] the assigned part 29th for other things instead there will be education or others and you can receive Federal Tax break employed for making us investments  Further questions, Don't have in this state. Further questions from members of the committee? Hearing none, Senator Hartsell has offered, I'm sorry Senator Wood excuse me, go ahead Mr. Chair. Senator [xx] have you considered decaffeinated coffee? Yeah. That's true, Senator Daivas Thank you Mr. Chairman, I have a question on the bill contributions to an account should be made only in cash. That's page two Section three, I presume that's opposed to property or , stocks sir or what does cash mean in this bill? Hossef? Senator Davis, I looked to that up and I am trying to find it right now but it all goes back to the Federal Government definition of I believe mind habitation of it is something liquid, I can find it for you in just few minutes Back to Senator Barenger[sp?] and her caffeineted coffee. Well you want to just

displace this bill for a couple of minutes while my staff does some research on the internet. It could be some other question if there is. Are there any other questions for members of the committee? Their agency whish to respond? Let's displace this place bill in the interest of time we'll come back to it. Thank you for your point. Senator Bingham Senate bill 286, there is a PCS, is there a motion to consider PCS to 268 Senator Woody[sp?], moves that we consider 268 PCS, all those in favor please say ay, all oppose say no, senator Bingham, you're recognized. Thank you Mr. Chairman ladies and gentlemen of the committee, this bill regulates the sale of e-liquid containers. President of the FDA does not require FDA child resistance camps on these e-liquid packages, this is an example of one, this contains nicotine, this can be absorbed through the skin of children, and there has been an incident of a youth dying from the exposure from this. So what this bill does, it requires child resistance packaging and violater will be charged with an A1 misdemeanour and they'll also be liable for the damages for any injured party. These e-cigarette refills come in candy flavours bubblegum chocolate and fruit flavors are very attractive to the youth and we all know that Nicotine is addictive and also causes serious health problems. This bill is endorsed by R. J [xx] and [xx] and the North Carolina child care task force. I'll be happy to try to answer any questions and I would urge your support. I understand that an incarceration report is going to be required if this bill it passes we'll go to the floor so we'll have to work out an incarceration report prior to that time. Any questions from members? Senator Wade recommends moves for favorable report to the PCS unfavorable as to the original bill, see no further questions. All those in favor of the motion will please say I all oppose no and the bill will be referred to the calender but take no that incarceration[sp?] report must accompany the bill Thank you Mr. Chairman now I can tuck a drink of this if think how much Senate Bill 371 Senator Hartsell Senate 371 is a P. S. C. Is there a motion to consider the P. C. S? Senator Rabon moves that we consider the P. C. S Senate bill 371 all those in favor say aye Aye  All oppose no, the Bill is before you. Thank you Mr. Chair, members of the committee, the P. C. S, but the bill itself identifies requirements for data reservation from the LMA, that's the folks like cardinal role, smoky mountain that the manage care organizations through the HSS, and the use of the information by the department. Many times, these claims are currently adjudicated whether it means reviewed and paid by the LME MCO, but then there is currently essentially a second adjudication that occurs that DHHS, we were trying to eliminate the unnecessary adjudicatory period, and also vote, there is a separate section that will require that the data for encounter data be submitted to the data analytics section, and I think there is a state agency so that we can manage that kind of information with regard to those these circumstances all together, there is a difference in submission of manage care type of circumstances Verses the typical physical health situations, and we're trying to avoid  unnecessary  side duplication by the process.

I'll be glad trying to answer any questions, folks from the department, I think everybody is on board with this now, I might add. Are there any questions from the members of the committee? Senator Randleman motion at the appropriate time. Hold on to that one second, are there any other comments or questions from members of the committee seeing none Senator Randleman moves for a favorable report as to the PC is the senate bill 371, does it have a referral on it? This will go to the floor, all those in and be unfavorable to the original bill, all those in favor will please say aye,  aye  all oppose no the motion caries and the bill moves forward. Thank you [xx] senator pay this for just a second while we check out this calender senate bill 235 has a PCS is their a motion that we considered senator Hise moves that we consider a PCS all those in favor please say aye, aye all oppose no, motion caries and PCS the senate bill 235 before senator Hartsell member of the committee sometimes this is a true sausage making process and in this case the sausage maybe become hamburger or might have become liver mash I'm not sure which my mistake the original bill health set up by state public health authority, this one deals with establishing an advisory council on rear diseases I might may be appropriate to have the staff discuss that I think it came from the justice Warren taskforce that's correct, but staff would you go over the bill with us please? OK, I'm sorry, I was working on the question. So the proposed Committee Substitute for this bill establishes the advisory council on rare diseases. If you look on your summary and the current law you can see that references the US code on the definition of rare disease or condition. Which means any disease or condition which affects less that 200, 000 persons in the US or affects more than 200, 000 in US persons for which there is no reasonable expectations that the cost of developing and making available in the United States the drugs for such disease or condition will be recovered from sales. So essentially this sets up an advisory council, you can see who the members are they are appointed by the secretary those members can serve for a term of three years and no member shall serve for more than two consecutive terms. There are also additional members which include the chairpersons of the legislative oversight committee on HSS and the secretary or her designee all headlines in the next session of the bill summary including the first five meetings that have taken place, not later that October 1st. So the clock is ticking and the bill will become effective July1st. The members elect their chairperson [xx] provides administrative support, powers and duties are outlined to coordinate efforts for study, [xx] on diseases, coordinate the performance of the advisory council duties, with other rare disease advisory bodies etcetera, research and identify parties relating to the quality and cost effect [xx] of an access to treatment and services, identify best practices for rare disease care, develop recommendations for effective strategies to raise public awareness, determine recommendations for best practices for ensuring that the public and healthcare providers

are sufficiently informed of the most effective strategies for recognizing and then treating rare diseases, develop recommendations for effective strategies to aid and determining any genetic environmental contributors to rare disease, they are required to report to the the Legislative Oversight Committee not later than January 1st 2015 and annually thereafter. Again it will become effective July 1, 2015. Thank you staff, Senator Robinson. Thank you, Mr. Chair. I have a couple of questions and may Staff may have to answer, is there a list of those specific rare diseases in North Carolina say a 100, 000 in the US for the population in North Carolina of course would of be specific to the disease entities so is there a list of quote what we consider those rare diseases in our state? Senator Robertson, I do not have a list, I do not know if one exists or if someone has compiled one, I do not have one. I might be able to add a little bit to that, I'm a member of the task force that came forward with this bill and there are, I've forgotten exactly what the figures are but there are several rare diseases from which people suffer and it's usually just in low numbers all across the Country but the task force saw enough interest in this to go forward with it. There is also a house bill in it, should receive a lot of attention now if we can get it through to General Assembly this year but right now I do not have those numbers I'd be glad to get them for you. Thank you Mr. Chair and I certainly support this bill because I think it is important. I just want to make sure it doesn't preclude specific disease entities Lupus affects thousands of people across our state and I've been looking at that and what we can bring forth in legislation on that as a specific one, but I just wanted to make that it didn't exclude those others which would have considerable numbers. Senator Davis you have your hand up did you have a question? Yes thank you Mr Chairman. I agree that rare diseases need to be examined. I'm just curious as to why this subgroup that you're talking about thought that the state was best place to do this rather than with NIA other federal programs and I have another question too now as a chair I can't stand up here and answer questions on the bill and I apologize that we probably are in haste to get this bill through. Because there's one coming from the house as well and we won't have further discussion on that. So this puts over to senate as well but right at the moment I don't have any further information I can give you. Follow-up? Yes follow-up. How do you measure the effectiveness of this group what scale or what protocol do you use? You're talking about the group of?   This advisory council. The justice warrant task force. Mr. Chair I could provide some insight on that? Miss, yes Teresa, please. Senator, I don't know that this would be a measure in terms of what you're thinking but it is there is an annual requirement that are report to legislative oversight committee on health and human services. So in the event that the oversight committee did not think that this advisory council was providing a valuable service to the state. Certainly all the members on that oversight committee are general assembly members and they could repeal the advisory council. So I think that gives you a little bit of a check and balance, I don't know that it gives you a quantifiable measure if that what you we're looking for.   Senator McKissick.   Appropriate time just move for a favorable report. Senator Hiese[sp?] you have a question? Just a comment real quick before we move forward, I'm very

supportive this from what it does I just want to say, I'm also very supportive of the original text of 235 and committed to finding another vehicle to assist in moving that forward as well. and I know a particular vehicle it's in this community that might be used are there any further questions? Sandra McKissick has moved for a favorable report as to the PCS for Senate Bill 235 unfavorable as to the original, without any further questions all those in favor please say Aye Aye. All opposed may say No, and the motion carries be we're going to make it through our calendar almost. Senate Bill 705 Before we do that, Senate Bill 367 has been doing a lot of work to get the terminology correct Senator Barringer, and I recognize Miss Teresa Thank you, Mr. Chair. I just wanted to confirm what I said before the committee that a cash contribution requirement is contained in the Federal Law for the Able Act. It does reference a section in the IRS Code that has to do with taxable gifts and not being a finance expert I did call a member of our finance staff to confirm, and probably the best analogy is for those of you who do your own taxes you'll know that when you record your contributions you have cash contributions and non-cash contributions, so cash contributions is similar in that respects, I don't think you can give artwork to the able plan if that helps, but again most the definitions in this bill are totally based on the Federal Able Act that was enacted in late 2014 further questions from the committee concerning senate bill 367 PCS Senator Houston [sp] Mr. Chairman, I think that will also mean that you wont be able to give real estate for instance, but you can sell the real estate any time in kind continue with the process with that I remove my motion for a favorable report what is your last statement, do you remove your motion? when you remove okay I thought you said remove okay  that sounds better we have a motion for a favorable report the PCS of 367 unfavorable as to the original bill any further discussion none all those in favor will please say aye all opposed may say no and the PCS carries does that go to finance okay thank you, thank you so much senate bill 609 is going to be displaced from today's this calendar is not ready for the step we have one more bill to go and we are going to get it done Senate Bill 705. Senate Bill 705 before we do that. There was editorial comment and one of the local newspapers about a week and a half ago concerning this bill and and the bill sponsors wanted to let you know that we'd want to fight back and put before you our little Dog and Pony show as well if you saw the editorial cartoon in paper there was a bulldozer with the likeness of three people that I will not mention on the bulldozer coming through on the decks property. So, here we are This cost great expense but

I'm going to keep it in the box, we're are to hold off from discussing this bill today, we have another meeting next week before the crossover and so at that time we'll discuss this thing greater detail I might even get it out of the box and I'll let it run around up here on the desk. Ladies and gentlemen if there is any further business to come before the committee today [xx] thank you for your quick work as we go through this calender and now the meeting is adjourned.