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Benchmarks Update
May 22, 2020
NC Cases: 21,122
NC Cases Hospitalized: 578
NC Deaths: 726
Counties: COVID-19 cases reported in all 100 counties
Recognizing YOU as Faces of the Frontline!!!
On Wednesday, May 27th, Benchmarks is taking out a full-page ad in the Raleigh News and Observer to recognize and thank all of you for being heroic frontline workers! We are requesting that all of you post on your social media sites the ad we have placed in the paper. We are trying to create a broad social media blitz across NC that recognizes all your amazing work. We have requested that the LME/MCOs share it along with the #CareForNC platform. Don't forget to share it with your staff and board members and encourage them to share it on their social media site as well.
This social media work is so important as legislators are planning out the budget for NC. We need legislative leaders to recognize you as frontline healthcare workers and realize critical need for your services to keep communities healthy and prosperous.
Don't forget that CareForNC is launching a COVID-19 #FacesOfTheFrontline campaign during May and June
. We work amongst healthcare warriors every day in our field and we're asking you to send in photos and short videos we can share to help our state and communities see the many faces of frontline workers!
These images will be used in our CareForNC campaign #FacesOfTheFrontline. Make sure you sign up to receive our #CareForNC posts and on our Facebook page so your agencies can repost the CareForNC posts! Be sure to use one or all the hashtags listed below on your agency posts.
- #FacesoftheFrontlines
- #NCHeroes
- #CareforNC
- #TogetherOnTheFrontLine
If you do not have a google account to use the Google drive, you can email your pictures and videos to
carefornc@gmail.com
.
Many video attachments may be too large to send via email. In that case, please upload your videos to YouTube privately, Dropbox, or use WeTransfer and send a link to the CareForNC email so we can download the file. Be sure to include:
- Your Name
- Organization name
- County or counties you serve
- Email
- Description of Content
- Any additional information
Below are some links to provide you additional information to help you create your own #FacesOfTheFronline posts and for video and picture submissions to CareForNC.
Phase Two
On Wednesday, Gov. Roy Cooper signed an executive order moving the state into a "modest" approach to Phase Two that goes into effect Friday at 5 p.m.
Phase two allows restaurants to open at 50% capacity for dine-in customers. Personal care services, like hair salons, can also open at 50% capacity. Workers at personal care businesses, must wear face coverings when they are within six feet of someone. Equipment and furniture that touch a customer must be cleaned and disinfected between customers. Swimming pools can also open at 50% capacity, with additional restrictions. Summer camps, including overnight camps, may also reopen with restrictions. Childcare centers may reopen to all families.
Bars, nightclubs, indoor fitness facilities, public playgrounds and indoor entertainment facilities like movie theaters and bowling alleys will remain closed. Mass gathering restrictions are no more than 10 people indoors and no more than 25 outdoors. Religious services are exempt from the order. Phase two is scheduled to run through June 26.
Cooper decided to make the move since the state is meeting three of its four benchmarks related to how the coronavirus is spreading throughout the state. North Carolina has leveled the number of people hospitalized by the virus, leveled the number of people presenting with COVID-like symptoms at hospital emergency departments and leveled the state's percentage of positive tests among overall test around 7%. The number of lab-confirmed cases is increasing but state leadership believes that is the result of the significant increase in the amount of statewide increased testing. Early on the state was averaging about 3,000 tests per day while now they average around 9,000 tests but some days have exceeded 12,000 tests.
NC DHHS also unveiled an
updated COVID-19 Dashboard
. The interactive dashboard provides an overview on the metrics and capacities that the state is following to inform decisions to responsibly ease measures that slow the spread of the virus.
Phase 2 Resources
Interim Guidance for:
NCDHHS Updates Guidance on Who Should be Tested for COVID-19
There is updated guidance on who should be tested for COVID-19. The new guidance recommends that clinicians test any patient in whom COVID-19 is suspected and ensure the following populations have access to testing, regardless of symptoms:
- Anyone with symptoms suggestive of COVID-19
- Close contacts of known positive cases, regardless of symptoms
- Persons who live in or have regular contact with high-risk settings (e.g., long-term care facility, homeless shelter, correctional facility, migrant farmworker camp)
- Persons who are at high risk of severe illness (e.g., people over 65 years of age, people of any age with underlying health conditions)
- Persons who come from historically marginalized populations
- Health care workers or first responders (e.g. EMS, law enforcement, fire department, military)
- Front-line and essential workers (grocery store clerks, gas station attendants, etc.) in settings where social distancing is difficult to maintain
COVID Tests
NC Department of Public Safety announced Saturday that all juveniles held at the Stonewall Jackson Youth Development Center will be tested for COVID-19 after a staff member reported testing positive for the coronavirus a day earlier. The employee of the juvenile correctional facility in Concord hasn't been onsite since May 10 after exhibiting symptoms and getting tested that same day. Currently no juveniles at the facility have shown COVID-19 symptoms.
The children in those units are being monitored twice a day for fever and other symptoms. All staff members believed to have had close contact with the sick employee will be tested and quarantined.
Budget Shortfall
The primary focus at the general assembly is the looming shortfall in the state budget that could be as high as $4 billion or around 16% of North Carolina's $25 billion budget. This shortfall could potentially require large cuts across state government.
More details on the deficit are expected later this week when legislative staff and the state budget office release a consensus revenue forecast. One bright note in this fiscal challenge is that NC has amassed a $1.2 billion-dollar rainy day fund to help offset the deficit. The state also has $1.7 billion in unappropriated funds from the current fiscal year due to a lack of budget being finalized last year. The final picture of the shortfall will not become completely clear until July when tax revenues are in.
Legislators are holding off on spending the remaining $1.97 out of the $3.5 billion Cares Act funds that came to NC until they receive guidance from the federal government about allowances to utilize the money to shore up the state budget.
Until the legislature received additional guidance around the CARES Act money, neither Cooper nor Berger have offered a timeline for a budget rollout. Both the House and the Senate are aiming to complete short session within four to six weeks (sometime in July), but if the guidance is slow to come from the federal government on utilizing the Cares money to fill in budget gaps, that could extend that time period out.
Budget Bills
Senate Republicans filed 18 budget-related bills Tuesday that they say are "must-do" priority appropriations for the legislative short session.
The bills lay out priorities but do not contain fiscal allocations because the state doesn't know how much money it will have to spend until the budget deficit picture is clear.
The bills include:
- a salary reserve fund for teacher, law enforcement and state employee pay
- funding for enrollment growth in K-12 schools, UNC, and community colleges
- retirement contributions and debt service
- Medicaid transformation
- a $623 million allocation to the savings reserve
- Raise the Age funding for juvenile justice facilities
- Department of Health and Human Services relocation
- repairs and renovation money for UNC and state agencies
DHHS Move
The Senate budget proposal
, Senate Bill 804,
outlines the priorities to move the DHHS headquarters from the Dorothea Dix campus, which will eventually become a Raleigh park. The bill
does not include a move to Granville County. Last session, Senate leaders added the requirement to move DHHS headquarters to Granville County as leverage to battle Gov Cooper over the Medicaid expansion he was seeking.
Medicaid Transformation
Senate Bill 808
, Medicaid Transformation Necessities, was introduced this week that would try to resurrect Medicaid Transformation. The bill, sponsored by Senator Brown, Harrington and Jackson, would start the Medicaid Transformation process no later than January 1, 2021. It would roll out the transformation process on a regional basis over five months. It does not contain the controversial components of the bill last session to move forward Medicaid Transformation such as the significant cuts to DHHS and transferring DHHS to Granville County.
House members we spoke with are supportive of the bill if it doesn't raise the controversial items again, but are doubtful that Governor Cooper would sign the bill without Medicaid Expansion that Senate leadership's position remains staunchly opposed to.
LME/MCO COVID-19 Request and Legislative Agenda
All seven LME/MCOs have worked together to develop a COVID-19 CARES Act fund request and a shared legislative agenda for short session.
The CARES Act request is for $81.4 million to cover COVID-19 related cares costs for this fiscal year. Some of the major items this funding would cover include provider reimbursement rates, the costs for moving to telehealth, housing and food for clients and financial stability payments to providers to keep them viable during the crisis. To see their
overview sheet click here.
Their legislative agenda requests:
- no new single-stream funding cuts
- Increase the innovation waiver slots
- use the additional alcohol sales during the pandemic toward SUD treatment
- support new funding to add emergency capacity Innovation Waiver slots for COVID-19 related situations
- Support sufficient allocation of PPE to behavioral Health providers
Benchmarks Legislative Agenda Short Session
Benchmarks will be supporting the CARES ACT request of the LME/MCOs as well as their legislative agenda items. In addition to those, Benchmarks is supporting the foster care rate reimbursement increase that was included in the last budget in Long Session that was vetoed by the governor and will be pressing to keep the telehealth services that increased quality and access that was implemented during the COVID-19 emergency orders.
We will be reaching out to specific members over the next week to help us with key legislators in their districts to move these agenda items. It will be a slow process until the guidance is received from the federal government as to whether the CARES Act funding can be used to plug the budget holes and the final numbers around the state budget shortfall. However, we need to have these items teed up and supported by legislators if they find funding is available.
Cherokee Indictments
A Cherokee County grand jury indicted Cindy Palmer, the former director for Cherokee County's Department of Social Services; former Child Protective Unit supervisor David Hughes; and former DSS attorney Scott Lindsay on three dozen felony and misdemeanor charges among them, related to a Cherokee County DSS practice of separating children from their parents without judicial oversight. They were booked into the Cherokee County Detention Center on Monday and Tuesday and are now free on an unsecured bond.
DSS employees often coerced families to sign custody and visitation agreements, or their children would be placed in a foster home, according to a federal lawsuit the parents have filed.
The documents were an illegal violation of parents' constitutional rights and "the product of both actual and constructive fraud on behalf of the Cherokee County Department of Social Services, its agents and employees, and attorney Scott Lindsay and Director Cindy Palmer," District Court Judge Tessa Sellers ruled in 2018.
VAYA Retainer Payments
Vaya Health previously provided retainer payment reimbursement at 60% of the service rate. They have amended this rate and will now provide this reimbursement at 100% of the service rate, retroactive to the start date of the Appendix K retainer payment program. They will not issue new approval letters to network providers.
NC CARES 360
Originally, NC CARES 360 planned to have referral sources in all 100 counties by December 2020. As a result of COVID-19 and the increased need for social service resources as unemployment exploded, NC Cares began expediting the onboarding process of referral agencies. By the end of May 2020, all 100 counties will have resources listed in the database system. Some counties may only have a few resources listed but they are working hard to increase those numbers as quickly as possible.
You can learn more about the NC CARES 360 response to COVID-19 here.
NC DSS
The $100 dollar reimbursement rate increase for children in foster care will not be distributed to providers before June. State DSS just received the funds and are working on guidance to send out to the County DSS agencies.
The legislation that passed waiving fingerprinting requirements for foster families, and replacing it with name-based background checks, is still not allowable at this time. The FBI is not allowing the SBI to move forward with the name-based checks as they do not believe the legislation clearly waives all the existing requirements. State DSS is still working on a solution around the issue to move forward name-based background checks.
Residential COVID-19 Restrictions
Gov Roy Cooper and Secretary Cohen have remained clear, in their press releases and even the most recent executive order, that residential facilities should not have visitors on campus. However, webinars hosted by DHHS for families, there has been mixed messaging around I/DD facilities where families were told they could visit if they were outside and maintained social distancing.
They also said that individuals in their homes could resume work in grocery stores but could not have visitors in the home. This has created a lot of confusion and we have reached out to DHHS through multiple channels asking that they clarify the directives for agencies with I/DD homes who are caught in the middle between the state orders for no visitors and the parents pressure to see their loved ones that has escalated due to the mixed messaging on the webinar calls.
We have also being hearing from our Children's Homes that there has been increasing pressure, especially after moving into phase one, from county DSS agencies to resume home and site visits. We reached out to NC DSS last week to request that they provide guidance to the counties on protocol on how to slowly resume visits with safety precautions in place. State DSS is currently working with DPH on that protocol that will hopefully be released next week.
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