January 13, 2020

What is the Joint Legislative Program Evaluation Oversight Committee?

The Program Evaluation Division (PED) is a central, non-partisan staff unit of the Legislative Services Commission at the North Carolina General Assembly, created in 2007. The Joint Legislative Program Evaluation Oversight Committee is made up of House and Senate members, and evaluates State agency programs through the PED. The mission is to evaluate whether State agencies or entities using State funds are operating in an effective and efficient manner. The committee sets a work plan for each biennium, and meets periodically over the interim.

Agenda

I. Legislatively Required Reports Relating to PED’s Inmate Health Care Series

Overview:

The committee recommended several inmate healthcare bills for the 2019- 2020 biennium. In response, the North Carolina General Assembly passed two related bills in 2019: S.L. 2019-135 (Inmate Health Care & 340B Program), and S.L. 2019-171 (PED/Safekeeper Health Care Cost Recov. Pract.). The presenters gave an update on the status of report requirements in the legislation, summarized below.

Report Summaries:

  • Increased use of and modification of processes at the Central Prison Healthcare Complex in Raleigh
    • The report from DPS stated it is taking steps to increase the use of the Central Prison Healthcare Complex, but does indicate how the services that will be expanded were selected, and DPS has not yet conducted the comparison of costs for in-house services versus outside services. It is unclear if the services that will be expanded have the greatest cost-savings. No cost estimates have been developed or provided.
  • 340B drug-purchasing for certain conditions
    • The law required DPS to report on its progress and savings achieved in purchasing certain medications through the federal 340B program.
    • Federal approval for the program had not been granted in time to submit the report.
  • 340B drug-purchasing by partnering with hospitals across the state
    • DPS did not follow the directive to hire a 340B consultant to assist in issuing the RFP for purchasing medications for inmates with high-cost medical conditions at local hospitals across the state’s four prison regions.
    • DPS stated they were awaiting HRSA approval (approved on 1/1/20), but PED contends that approval is not related to the requirement to partner with private hospitals.
    • DPS stated that since they now have HRSA approval, they are in the process of developing processes, procedures, and staff training.
    • DPS is in the process of creating a full-time position stationed in the Apex pharmacy to monitor the entire program.
  •  340B drug purchasing through partnering with UNC Health Care
    • The law required DPS to partner with UNC Health Care to purchase inmate medications through UNCHC’s 340B program and to pass through savings to DPS.
    • DPS’s report stated that they are not at a point to assess the complexities of the partnership with UNCHC.
  • Updated charges for Safekeepers health services
    • The law required DPS to report on the updated medical services schedule of charges it assesses for Safekeepers.
    • DPS submitted a report, but there is no data available yet for the charge assessments.
  • Telemedicine pilot program
    • The law required DPS to report on the assessment criteria it intends to use in evaluating the success of the telemedicine pilot program.
    • DPS submitted a report, but there was no data available yet on how it is being implemented.

PED stated that they recognize how complex this issue is and responded by hiring a consultant to help with timelines and implementation. Legislators seemed frustrated with the lack of information and implementation of the legislation from DPS and UNCHC. They highlighted the need for a clear plan and timeline for moving forward.

II. Bills for Consideration for JLPEOC Recommendation

Based on the committee’s evaluation of two state agencies, two bills were recommended and approved to be taken up during the 2020 short session.

DEQ Organizational Structure

  • The proposed legislation made recommendations pertaining to the organizational structure and permitting processes of the Department of Environmental Quality, as recommended by the PED report.

CPS Intake Screening

  • The proposed legislation would prohibit county departments of social services from implementing child protective services intake screening criteria that is more stringent than, or in addition to, State policy; and would require the Department of Health and Human Services, Division of Social Services, to make various policy changes as a means to improve the child protective services intake screening process, as recommended by the PED report.