Short Session – Short on Debate!

As The Empowered Advocate reported in our last newsletter, legislators came back to the General Assembly like gang busters. 

One of the first pieces of legislation to be introduced was an amended state budget. Not introduced under typical procedure – where it would have been brought to the floor and available for debate and amendments – it was introduced as a conference report within the shell of S99 – an automobile insurance bill. Granted that this is an amendment to an already approved biennial budget, the amendments are not insignificant.

This process is known as PCS or Proposed Committee Substitute. PCS essentially means that legislators take a bill that is going through committee and with the support of that bill's sponsor, remove all the language and insert something entirely different as a "substitute" - in this instance, a conference report.

Because a conference report is considered the final product of House and Senate negotiations on an already-filed bill, General Assembly procedures would provide only for a “yea” or “nay” (or up and down) vote with no allowance for changes or amendments.

This unprecedented move has caused havoc among Democratic legislators who see this lack of transparency as a mechanism to avoid debate on hot button issues such as teacher pay and school safety.  State House Democratic Leader Darren Jackson said of the issue:
"I am unaware of any instance in modern North Carolina history where the state budget was amended via process that did not allow for committee consideration, committee amendments, and floor amendments.”

The House & Senate Committees on Appropriations met jointly on Tuesday, May 29th at 10 AM in Room 643 LOB to consider S99, and APNC joined the standing room only historical moment, Tweeting live from @YourAPNC.

S99 currently still includes:

  • $10 million in grants for mental health professionals including school nurses
Governor Cooper’s budget by contrast expands funding by $40 million, which would allow school districts to hire an additional 531 instructional support personnel ( school nurses, psychologists, and counselors).
  • $3 million for mental health training for school staff
  • $2 million for nonprofits who work with students in crisis

  • Reduces single stream funding to LME/MCOs. $438,041 recurring and $16,583,635 nonrecurring.
  • $500,000 in nonrecurring funds for Traumatic Brain Injury services
  • Amends risk categories for Medicaid. This move allows outpatient providers and behavioral health and I/DD provider agencies that are nationally accredited to be considered low risk. 

Legislators are hoping to pass this budget through this week. If you wish to see additional investments in behavioral health programs, you should call your lawmaker soon.

The HOPE Act
Coming out of the Attorney General's office is a bill proposing to allow local law enforcement access to the NC Controlled Substance Reporting System, modifies sentencing specific to opioid possession, and creates a significant new criminal offense: Death by Distribution of Certain Controlled Substances

Upon request from the NC Attorney General's Office, APNC delivered feedback expressing our concerns about The HOPE Act:

1. " that allowing local law enforcement access to CSRS data presents a potential threat to civil liberties not outweighed by any possible benefit to North Carolinians...  especially now that the largest threat to public safety and health is illicit heroin and fentanyl."

2. " the sentencing piece... seems to indicate a potential culture shift in a backwards direction, regarding criminalizing pathology."

3.The inclusion of  Death by Distribution of Certain Controlled Substances  happened after our feedback was solicited. Naturally, this section raises concerns. If sponsors wish to call this an  enforcement  act, that is one thing; But, to assert that sentencing impacts  prevention  is to show that one has been asleep at the wheel for decades. This piece did not originate from AG Stein's office. DA's from regions of NC hard hit by the opioid epidemic pursued this inclusion.

The CSRS was intended "to improve the State's ability to identify controlled substance abusers or misusers and refer them for treatment, and to identify and stop diversion of prescription drugs in an efficient and cost-effective manner that will not impede the appropriate medical utilization of licit controlled substances.”

We are grateful for AG Stein's continued pro-recovery message and acknowledge its value to our movement. We admit that rigorous guidelines and training for CSRS use and penalties for abuse are included in the bill's language. We also note the generous $10 million appropriations recommendation for community-based treatment and recovery support.

However, we remain concerned and have voiced that to the AG's office. If you have concerns, we recommend that you voice those to your representatives.

Artificial revenue caps 
TEA reported last time on rumors that the General Assembly plans on introducing artificial revenue caps, possibly via a constitutional amendment capping North Carolina’s income tax.

For example,  SB75 would create a constitutional amendment capping our state’s income tax rate at 5.5 percent. This and already-passed tax cuts will leave the state with $3.5 billion less in revenue to invest in social services and education.

Other items working their way through the legislative docket this short session include:

ABC Regulation and Reform ( HB944 & SB714 ) - both of these bills are in committee and would "strengthen the permitting enforcement authority of the ABC Commission and make other changes to the ABC Laws as recommended by the joint legislative oversight committee on justice and public safety." Outlines qualifications for permits, penalties for violations, and definitions concerning establishments.
Advocacy 101 and Partnerships

APNC is partnering with NC Child, a North Carolina organization that advocates for children on the release of a report entitled: The Child Welfare Impact of the Opioid Epidemic. The organization sought the help of APNC to use accurate ad non-stigmatizing language in their report which is due out in June. TEA will circulate it upon release.

In addition, the two organizations are working to align advocacy priorities around the passage of Carolina Cares ( HB 662 ) which in absence of Medicaid expansion, would provide health care options for low- to middle-income families – including children and SUD services.

Read more details of NC Child’s priorities here.

As you continue in your advocacy goals, remember these actions to be most effective:

  • Remind yourself of our Policy Advocacy Core Values;
  • Take the time to find out who represents you and how to reach them; 
  • Keep up to date on the NCGA legislative calendar here;  
  • The NCGA broadcasts live, real-time audio of the daily House and Senate sessions, press conferences in the Press Conference Room, and meetings held in the Appropriations and Finance Committee Rooms. Click here to listen in;
  • Revisit how bills become law so you know the different methods of advocacy along the way; and
Profile in Advocacy

I'm delighted that Amanda Flory, is my Profile in Advocacy this week .  

Amanda, is a Transitional Care Social worker, with the HOPE Initiative and a champion advocate for those suffering from the disease of addiction. She was brought on in May, 2016 through a funded position from the County of Nash, to work directly with participants in the HOPE Initiative. Hope Initiative participants are those with substance use disorders seeking treatment and recovery.

Her anonymous nominator says, "During the past 2 years, Amanda has shown a commitment and compassion for others through her work that often goes beyond her scheduled work hours. 

During this time, Amanda has been directly involved with placing HOPE Initiative participants (over 350) on their path to recovery. In addition to her work with the HOPE Initiative, she leads the Coalition for Addiction Recovery and Education (C.A.R.E.) and was instrumental in the planning and execution of a Syringe Exchange Program (April 2017) and a Recovery Community Center (July 2018) for Nash County.  

In addition, she has made presentations to county commissioners, coalition groups, and police agencies across the state to further advocate for more treatment and pathways for those suffering from substance use disorders. 

She has also forged partnerships with treatment facilities and other groups such as APNC, NCHRC, NCRC, etc. 

This is just some of the work that Amanda has done over the past two years and her desire to make the world a better place is beyond anything I have seen. Her tireless effort to advocate for those in need shows a level of dedication and professionalism that the profession of social work can be very proud of indeed."

Amanda answered my 5 standard questions:

1.        Advocate, from Latin advocatus means "one called to aid (another)”. What moves you to aid others in this way?
I personally feel everyone has an obligation to help others, whether it’s through small acts of kindness or dedicating your life to the service of others. I had a strong desire from a young age to work with people and to help, in some capacity, enact positive change in our world. I feel extremely fortunate that I have been given a platform through my professional work to help others in their time of need, and hopefully make their world a little bit better.  

2.        What’s the single most important character trait that makes an effective advocate?
There are a multitude of characteristics that make an effective advocate, but if I had to choose one it would be to genuinely care about those you’re working with. Any helping profession has numerous challenges, and I think many of us struggle with not being able to solve every problem or when outcomes aren’t what we had hoped for. I think when people know we genuinely care about them though, they feel seen, heard, and validated. Within that lies the catalyst for being able to effectively advocate for their needs.

3.        Share with us an advocacy story from your work – one in which you are most proud or where you learned the most.
I’ve been impacted by everyone I’ve worked with, some more significantly than others, and have also learned through each relationship. It’s difficult to pinpoint something that I’m most proud of, but there are a few people that will be forever memorable. I’m most proud of these, for the trust they put in me in their time of need and for the courage it took them to share their wants, needs, fears, and hopes with me. They allowed me to serve as their advocate and trusted me to empower them with what they needed at the time.  

4.        When you look back, how will you measure your success as an advocate?
I hope I’m able to measure my success through the happiness of others around me and those that I’ve worked with. Few things are more special than seeing someone that is doing well, healthy and happy in life, and knowing how far they’ve come and everything they’ve overcame to get to this point. Advocacy is not always an easy thing, but the outcomes are often times immeasurable.  

5.        Tomato-based or vinegar?
I’ve been a vegetarian for the past nine years, so my BBQ days are over. However, born and raised in Eastern NC, I have to say that BBQ isn’t BBQ unless it’s vinegar-based.

If you have suggested topics for Advocacy 101 or know someone we should feature in Profile in Advocacy , do let me know.

Until next time,

Kathleen Lowe, MSW
Policy & Advocacy Specialist
Partners in Action

Budget Amendment Concerns from The Coalition
The Coalition prepared a short list of budget concerns and encourages you to reach out to your legislators to recommend fixes in the technical corrections bill.

Close the Gap Advocacy Day - June 26th
Join this annual event hosted by a coalition of non-profits focused on expanding access to healthcare for all North Carolinians. Learn more and sign up here .

1 in 5 personally knows someone addicted to opioids
The Hill reported that a new s urvey by The Federal Reserve included for the first time questions related to opiods. The Reserve's annual report on the economic well-being of U.S. households found that white adults were twice as likely to be personally exposed to opioid addiction as black or Hispanic adults. 

Opioid Legislation coming to Congress
National Council reports that after a flurry of activity on the US House side, the US Senate are taking up opioids with a view for federal legislation in due course.

Certified Community Behavioral Health Clinics transforming opioid addiction treatment access.
National Council report highlights how CCBHCs are filling in the gap of treatment.

In the News

LA Times explores the connection between drug company payments and opioid prescriptions concluding that link between prescriptions deserves further scrutiny.

AG Stein sues Purdue Pharma. The Attorney General joins law enforcement leaders in other states and counties across the U.S. who are accusing the pharmaceutical giant of deliberately misleading physicians to make a profit.

Coalition hosts prayer breakfast to end health care coverage gap.

For the first time in history, Democrats have contenders in each of the 100 counties for the November elections. They recently unveiled their unified platform to engage voters across the state and will gather at the McKimmon Center in Raleigh for their convention June 9th.

Meanwhile, NC Republicans are gearing up for their convention June 7-9 in Hickory.
Alerts & Calls to Action

Fair Chance Hiring

Our Executive Director, Donald McDonald, tells communities that he is thriving in recovery from mental health and substance use disorders. He often says, “I got well; then I got better than well .” He reminds us that when he sought help for his drug problem, he had immediate access to adequate and appropriate treatment and years of robust recovery supports in his own community. Hence, he got well and stayed well. We get better than well when we have the opportunity fully to rejoin society and chase our dreams.
Our Collegiate Recovery Program Coordinator, Chris Campau, recently celebrated 12 years of thriving in recovery . We helped Chris celebrate by posting about it on Facebook at @YourAPNC. We wrote that "Chris is a loving husband, dependable father, social worker, most excellent friend & colleague, and recovery movement leader. He is living proof that we get better than well when, along with hard work, three crucial ingredients of thriving recovery are present:

1. Immediate access to adequate and appropriate treatment services;
2. Robust recovery support services for at least 5 years; &
3. The unrestrained opportunity to chase dreams!

This is the recipe for success that everybody experiencing substance use disorders deserves. Nicely done, Chris!"

Frequently, obstacles stand in the way of our achieving recovery actualization. Many people in recovery have experienced criminal justice system entanglements as a direct result of their disease. They may find wellness, but a felony background can keep them from employment, housing, or going back to school. Donald didn’t experience this obstacle because he avoided such entanglements through dumb luck. If only there were some policy to afford less fortunate folks a second chance. 

Perhaps you can help with that. Read more about Fair Chance Hiring on the NC Harm Reduction Coalition’s web site. Consider calling your representatives in the NC General Assembly to voice your support for H409 .

Supported in part through funding from the NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services via the Substance Abuse Prevention and Treatment Block Grant at the Substance Abuse and
Mental Health Services Administration.
APNC, a proud affiliate of NAADAC, represents the interests of over 8,000 licensed and certified prevention, treatment, and recovery professionals throughout North Carolina. Member dues ensure that we are able to continue engaging in deliberate education and vigilant advocacy in our pursuit to empower our professionals to thrive. Consider joining APNC as an individual or organization today. Visit our web site to learn more.