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House | June 3, 2015 | Committee Room | Health

Full MP3 Audio File

I will call our health committee meeting to order our sergeant at arms this morning Young Bay, Bill Moyes, and Gem Millan. Thank you for what you do we do have a few pages I see. Michael Smith if you are here raise your hand. Mecklenburg, [xx] Moore, Jakira Steve, Bens[sp?] county representative Baskervile, thank you for being here. Scarotig, Wake county, Brian Brya, Collins Winstend, Person county Lay Yabo and Ona[sp?] O. J back to back. Cumberland Representative Gracier. Thank you I have been here we hope you have a great experience this week, we have three bills this morning three Senate Bills that we are hearing. Senator Barigle is here and I understand we are going to carry the load for three, you're doing yeoman's work this morning we will start with senate bill 366. Senator Barringer. Thank you Mr. Chair, good morning I appreciate the opportunity to be here the first this bill that we are going to discuss today is senate bill 366, what this bill does, is a little background myself and Representative Avilla Chair the permanency innovation initiative committee that is looking for innovative ways to place our older foster youth into permanent hands and this committee is met for about a year and having gone through that committee process we are now asking for few corrections on how we operate or clarifications and there are just two, the first was not clear when we should be making our committee report and what this does it says it will be done by February 15th so that it will be meaningful to the general assembly to proceed as suggested, and I see you are here, Representative Avilla is here today the statement here is we discover the original bill as he said here with me that and is quaralling[sp] this community is not mean when we were in session and say we would make even possible to meet quaterly, and say what this bill as it says to meet atleast, twice a year orientation is to meet possible in your argument so only you know, is that but it is not possible to meet quarterly while we were in session and so our community bill to you and say I saw this in the bible see as well in that question is that reads the question and see as it you have seen heavily, this promotion hold it first, pause the question, okay no, pause the qu estion Reckejack [xx] is into and will turn back to representative [xx] for a motion. Thank you Mr chair mentioned for senate bill 36 66 and I do not see a referral so [xx] That's correct. Okay. All those in favor say any opposed? There is another there is PCS here on the Senate Bill 487, so I need the motion to accept the PCS Representative Brown so moved and that is in front of us now. And Mr. Chair, inquiry of the chair Yes mam In the senate rule it would be customary for us to determine who would carry the [xx] on the floor Okay, Representative [xx] will be willing to that   She will be, in fact she will be happy to do that, Okay Thank you Mr. Chair Health toward technical divisions and will you have the motion to accept the PCS. All those in favor of this say aye, Aye! Any oppose case Senator Bearing Thank you Mr. Chair members of the committee what this bill does is makes primarily technical corrections because what it happen again by point of background when the state healthcare plan move the health choice program into medicaid some of the language is not consistence and so what this bill does is make those changes, those technical changes against conforming changes in the law. It also repeals the child health insurance fund and the reason for that repeal is that fund was never funded and so its just sitting there unfunded. Members of the department are here to answer any other question since this is a very technical bill and I offer it to you Representative Blackwell Just a quick question to inform myself on the second page in section four we're adding a senate that says that payments to providers will be paid in full and not subject to cost settlement,

what exactly does that mean?   Senator [xx] I do think I think I can take that question. It's not, I see Adam Scoulders here from the department. My understanding, first of all that is what is currently happening now is the clarification to verify or to confirm whether that process will continue, ordinarily in hospital setting, mid way through there will be an estimate of cost and then in there will be a cost settlement, which will respect to the health twice plan, they do not do that cost settlement now, this just confirms that they will continue not to not do that someone.  Follow up Mr. Chairman.  meaning that someone at the hospital or the provider bills, and they get paid for the service rather than paid on the basis on the estimate, and settling up later finally. I think I'm getting the node from the department that yes, that is a correct interpretation of that language. Representative Dobson. Thank you Mr. Chairman, one question lead to starting on line 49. It talks about, the plan shall report periodically to the Joint Legislative Oversight Committee on Health and Human Services will this just become a ruling to DMA in general or is that be taking out together, that reporting requirement. And I will like to divide the department on that particular issue. Okay, you come forward from the department state your name. Thank you Mr. Chairman. I'm sure with the HHS their in department is supposed to be statues being taken out, and that was also done in the house budget, I like this entire section was appealed, section C was appealed in the house budget, as was anything else that the department has, It's always available anytime and I think this originated whenever it was multiple departments using this information. Thank you. Representative Dopson says, no other questions? Do I have a motion to accept? this year's favor book unfairable to the regional President Blackwell so moved all those (xx) all those on the favor say I, I in the oppose okay let's see who is the likely guilty party to carry this in the house I will take a volunteer since it sets the way for the bill Representative John say he would be gland to take care of that this is matter of technical corrections Thank you ladies and gentles, okay we have a (xx) full family acts Senate Bill 423 Senator (xx)  Thank you Mr. Chair, now I get to get really excited. Very excited. This's a great day in North Carolina because I get to talk about something that's so important to all of us. It's our foster care system and the children between 10, 000 children in our stay who live in foster care and 500 every year that finish their careers as children aged at foster care. This particular bill is to foster family act. What I have discovered since I came down here three year ago, is that people do not understand what happen in foster care. That they did not understand the life of a foster child, and having been a foster mother for [xx] foster care for 10 years, I know a little bit about what that is like. The children come from very often very abusive at least very neglectful backgrounds. They had quite a history of abusing neglect, I had children in my home who'd been locked in closets, in the dark strapped in the car seats, hours on end, not fed, not changed. I've had children aged three months who'd been sexually abused if used in my house life lighted the Chapel Hill, and so they start their life out that way, and then they come into the foster care system and every child, every human being needs a family, and what we have as a state is try to create a family for these children. Well what we did, what we have done in this foster care system, up until now, is bring them into a family, and they can sit on the sidelines of life they generally are not allowed to do the normal extra curricular activities like going field trips with their schools, be able to play high school or middle school sports participate in over night activities like girls scout, camping trips, boys scout camping trips, church retreat because there is nobody there to sign the permission slip nobody to

sign the permission slip they are not allowed to learn to drive a car in those places so imagine being aged out at age 18 where your are what ever you are doing and you can't even drive on my bill how do you get to work, how do you person in life, what this bill does it does several things first of all, the basis of the bill is in the name of the bill it is the port normal family life and reduce the stigma of being a foster child having to sit on sideline of life it establishes the prudent parent stand due to parent stand obvious basically says that both foster the father and the mother can make a reasonable this agence about whether that child can go out on field trip with school or over night with a friend I would like to read from the statue because I think it is very well drafted it is characterized by careful intensible parental decisions that maintain a child's health, safety and best interest while encouraging a child's emotional developmental growth and what this will do is it will allow these children to not have to sit back in the principal's office when the rest of the school is going to the bill more house or down here to the capital or whatever it might be. I was in the seminar about a week ago a couple of weeks ago and I heard an aged out foster woman who has really put her life together, talk about a very hurtful time in her her life. She had been in 16 foster placement and about midway she had been placed with a family that had really embraced her and loved her and it was a modest family and the family had saved to go into Disney World, and they wanted to take her and her sister who were foster children with their family, so the mother got an extra job, to save up to pay for that, and so the mother has the the extra job, the children are anticipating getting to go to Disney World and when it all happened they didn't get to go to Disney World. Because there was no reasonably prudent parent standard and I sat there last week and watched this very put together survivor of our foster care system almost moved to tears remembering when she was 12 years old and she couldn't go to Disney World after her foster mother had done all of that sacrificing. So it's not just about the child, it's also about the family, it's about the mothers and the fathers and the children that are in the family. Another thing this bill does besides that is that it provides a venue for a foster child to be able to obtain a drivers licence, and I will tell you that the department of insurance and great beural has worked very hard add on this particular piece and another part of the bill and this came to my attention from two apulanchine[sp?] state to the professors who happen to teach insurance and who are also one is a foster parent and the other had been a foster parent in the other state but has chosen not to be a foster parent here because we do not have impossibility for foster parents to purchase any kind of liability insurance for being a foster and I would like to personally thank Dr. David Mollet[sp?] and Dr. Jemies Pierson for their work on this bill calling this to our attention working with the right beaural to make that happen so that's part of the family act two and critical to the family act because we cant recruit good families if they cant be protected from liability with insurance and Doctor Person said that until we have that opportunity she was not going to be a foster parent in the state excuse me, ask the question now then, at the appropriate time I would like to move a favorable report, OK I know she's very passionate about this, so let's let her finish. We've got a little bit of time. I'm very, very passionate, I appreciate it many times. I love it. Well it's been described in many ways and I like the passion for it, a few other things about the bill and I could go on and so I won't. one of our senators tells us you can talk us out of a good bill, so very quickly part of the bill that might need a little bit of explaining is the part that directs the DHHS to investigate and put together but not file, a 1915 C waver for children with serious emotional disturbances and the reason I told you about those children that have been in my home was to give you an idea of how many of the population of the foster children there is no wonder you have serious emotional disturbances if you are locked in a closet and horribly abused and so this would allowed and what that does is many of these children run an actually institutional us they are not able be in families and so our hope is to this 1915 sea weaver we would be able to have more flexibility and that will be less cost and certainly

so much better to get these children in communities and families. I think that very much to key points, I'll be happy to answer also we have some staffs here that might be able to answer any technical parts of the bill and so I would now yield and opt to question.  Okay thank you, and now a few questions and I'll start with Representative Blackwil thank you Mr. Chairman. I think this is a wonderful bill, well motivated and my question isn't intended to reign on anybody's parade, but just a concern, Dedan[sp?], I'm reading it, frankly, for the first time, and it relates to the reasonable and prudent stand on which strikes made it worded, possibly a little bit of a high level, and I wonder if that is the intent or if I'm misreading, and let me explain to you what I mean, it say that, it is careful and sends for parental decisions that maintain a child's health and best interest. Do we want to say that it must maintain them, or do we want to say that it is designed or intended to because it seems to me a parent could carefully and sensibly choose to authorize a behavior that was designed or intended to serve a good interest but something could go wrong. In that instance so I would not see the foster parent unless it's something we could all agree was a foolish choice or a pattern of mis-judgement, that we want them to fail to measure up to the standard because it didn't maintain, but So, that's just a question, as to whether that might be tweaked a little bit. Okay, We're hearing. Representative Blackwill, I appreciate your comment. Would you that language again designed? I see the language in the bill but you had suggested an alternative? I'm contempt the legal stuff come up with the best way, Representative Bishop has whispered in my ear, we can say reasonably expected to maintain, you could say designed to, or intended to, I think any of those formulations probably would work to sort of just a little bit. I think that's an excellent suggestion, if I might then work with staff and see what we can do. This has another in the judiciary committee, and so between now and then will see what we can do. One of the things we did do that I did not highlight is that was not in the House Bill, but is in the Senate Bill and I did talk with the sponsors over here and they were, Representative Glacier and Representative Stevens now by clear and convincing evidence to breach the prudent parent standard. So, that's a good thing, but this is also in the same vein and I like suggestions, the letters work it a little bit, thank you representative Blackwell. Okay representative Avra thank you Mr Chairman my question is along the same subject of reasonable and prudent parenting standard where is that to fund where is that described because what I think is reasonable parenting there is a few people that don't raise their kids that way and not disagree with that so how do we define that? Thank you Representative Avra for the question in two ways first of all from a regal stand point it's basically a version of the reasonable person standard and we leave with that in the law all the time because is what 12 jaws would say of reasonable behaviour could be, but that's really the attempt that's been made at the bottom of the first page of the bill is to define what that standard is and as I said what we are looking at is to make it reasonably expect perhaps design to so that we don't box in someone if there is a bad outcome even though there was a reasonable choice at the time and so your questions well taken, but that that's really the point of that section A is to nail down the corners of what we mean there. Okay Representative Lucas. Thank you Mr. Chair Senator Balla Jell I want to commend you for bringing fourth such a wonderful bill really highlights many of the concerns that I've heard for a number of years as it relates to plight of foster children who do know out of their own and really made it disadvantage. I've just because of societal conditions, they can't help who their parents are, they

can't help the conditions that really the veil over them, that's sometimes quite often negative that resulted in children having to be removed from the home. And they deserved they've as much a normal life as they can. And I think this bill goes a long way towards doing that and I commend you for it. Thank you. Okay Representative Dollar. Thank you Mr Chairman I have couple of different things I would note whatever people want to potentially do in terms of the reasonable prudent parenting standards that is we did pass that in the house that same language we passed at the house and sent to the senate so that's identical language to what we passed in house bill 407 would note for the record and don't get too concerned about the Senator Barringer but the house passed it's bill on the 27th and send it to the senate on the 28th the Senate passed it's bill on the 28th and then send it to the 29th so I just want that noted so that the same courteous is extended to the house on some other piece of legislation. what I'm saying. So anyway but I got a question on page two I got two quick questions. One under section under further on under section 2.1 under f and g under 4 7 f is a little different it looks like maybe f and g and this version and the senate version is broken up can the staff explain what is or you can Senator can explain what's going on there with F and G and then I had one other area that I want to ask on. Okay Senator Barringer yes that was the point that I was making before that I had in my introductory remark, it's the clear and convincing evidence when we put that in we change that paragraph around so in F what it does it does two things. First of all it says that that prunent parent standard, if it is violated has to be demonstrated by clear and convincing evidence not just popondrus[sp?] more likely than not they're just the simple scale of justice. Also it makes it clear that if there's gross negligence, willful or wonted conduct or intentional wrong doing that that's not part of a prunent standard and so we're raising the bar for proof for the prunent parent standard violation but we're also and it was on the prior bill but certainly gross negligence, willfulness and mounted horrible conduct will not be tolerated and [xx] we had one more? Yes sir. Thank you Mr. Chairman. Okay and on page five and you may have already covered this as well and I just wasn't picking it up on my ears, you have a section 4.4 that the House didn't have and there were some little different rewarding of section 4.3 than from the house version of the bill Let me check this Can you just tell us what the difference would be there on those two sections. Yes, we're talking about 4.3 4.3 and you have 4.4 which we didn't have in force.   Yes, in the meantime as the bill followed through I've been working with the Wright Bureau because this are the insurance policy provisions and they asked for this language to be put in so that they could actually provide. This is the liability insurance part and so this were the request of the reburial to make sure that they were in a position to be able to do what this bill does.   Okay don't take away from anything in the prior just is a clarification to make more operative Representative [xx]. Thank you. Thank you Mr. Chairman, and thank you Senator. This is a wonderful bail of problem and nobody thought of existed, and your presentation brought me to tears. It's a great Bill and thanks very much for doing it. Okay, Representative Bowley Thank you Mr Chairman. Senator, I seem to recall earlier this year discussions of extending the age protection on foster children, that under current laws I understand a child turns 18 in the middle on their senior year of high school, they still age out in the middle of the school year. Granted I'm not as up

speed on this issue for the technical point of view but I notice that your bill does not address that. Are you confident that, that issue is addressed in another bill? Senator Absolutely, it was heard yesterday in a judiciary the original work of this was in several bills, and a Liability Insurance Bill Prudent Parent Standard Bill, or whatever. And efficiency, and also really consistency, the foster care reforms in two bills now. Primarily because ageing out part has a significant physical impact and so it needs to be looked at in a somewhat different way than this, but absolutely these children are left on the street at age 18. Many of them are just juniors in high school, almost all of them are based[sp?] seniors in high school. That's where I was as I turned 18 December my senior year and we just turned them out and the pipeline, the prison to pregnancies, abuse. Interestingly, that's not the subject of this bill[sp?] with the chairs indulgence out State of California, several years ago, many years ago, discovered they had an explosion in their prison population and they discovered that is because of foster children and why [xx] California to reform there foster care system because they couldn't afford it in the backyard and we are the same direction not necessarily with the prison but all of it it's very costly so thank you for the question but yes it is in another bill that is moving through the process. Other questions? If no I will come back to representative Farmer Butterfield for a motion, and this does has, have the referrals to Judiciary Three. Thank you Mr. Chair. I move that committee substitutes Senate Bill 423 be given a favor of a report to the original and repair to J3   So you have heard the motion all those in favor say aye. [xx] is not a PCS Senate Bill 423. OK. Thank you. We'll fix it. You've heard the motion, all those in favor say Aye, "Aye" post, it passes. Senator Baringer thank you for your work all through those bill thank you for your passion and I hope you get back to senate, share the fact that you had so much love from this committee, I will Mr. Chair thank you committee members have you thought fore manager eventually come out, you can do that after judiciary, Okay okay, she is a likely one. Very good. Okay, we no other business for this committee, this committee is adjourned.