Health care, not handcuffs, says NC governor in pitch for Medicaid expansion funding

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New Medicaid expansion backed by Gov. Roy Cooper would strengthen mental health care and substance abuse services for inmates, the North Carolina governor said Friday.

Even though lawmakers have not yet approved the funding, Cooper’s Wednesday announcement on his administration’s plan to expand Medicaid on Oct. 1 now pressures the state’s Republican-controlled legislature to act, as the News & Observer reported this week.

Mentally-ill prisoners disproportionately experience mental or behavioral health issues and experts have said those in the jail population will especially benefit from expansion in North Carolina. Statewide, more than 600,000 people are expected to be eligible for the program and gain new health care coverage.

On Friday, Cooper was visiting Mecklenburg County Sheriff’s Office Summer Camp, held for the first time this year at the former Juvenile Detention Center in north Charlotte. Sheriff Garry McFadden stood alongside Cooper as kids wrapped up their third week in the “Escape Camp” by learning archery.

Asked about a case like Devalos Perkins’ — a 37-year-old Charlotte murder suspect who has been waiting more than 10 years in jail due to his mental health condition and a one-word loophole in state law — Cooper pointed to Medicaid expanding as part of a solution for a broken system.

“We know that we’ve underfunded our behavioral and mental health system significantly over the last few years,” Cooper said.

Earlier this month, The Charlotte Observer’s “Purgatory” — a four-part series about Perkins — revealed legal ambiguity and a one-word loophole in state law allows criminal defendants like him to wait years, and even more than a decade in some cases, to go to trial if they are deemed mentally-incapable of proceeding to trial.

“Our Department of Health and Human Services already has a program going on here in Charlotte-Mecklenburg to help restore capacity for people,” Cooper said. “... It’s so important for people who have been found to be mentally incapacitated in order to be able to stand trial.”

With not enough room in psychiatric hospitals, North Carolina is focusing on providing local resources for those with mental health and substance abuse issues — those who know “they shouldn’t have handcuffs, they should have health care,” Cooper said.

Investment in health care would help the criminal justice system more than anything else, Cooper said.

Republican and Democratic sheriffs alike understand that, the governor said, and that’s why the North Carolina Sheriff’s Association endorsed Medicaid expansion.

Republican legislators previously declined to fund Medicaid separately and instead tied it to the budget.

House Speaker Tim Moore told reporters last week he has “not sensed any appetite in our caucus to move the expansion separate and apart from the budget.”

“So I would anticipate any expansion that happens on Medicaid to be a part of the budget that’s enacted,” Moore said.

On that, Cooper has said in a statement: “Making Medicaid Expansion contingent on passing the budget was and is unnecessary, and now the failure of Republican legislators to pass the budget is ripping health care away from thousands of real people and costing our state and our hospitals millions of dollars.”

Lawmakers have until Sept. 1 to fund Cooper’s proposal. If they miss the deadline, Medicaid expansion in the state would be delayed until Dec. 1, health officials told Politico.

It’s unclear how much of the new Medicaid spending would go directly toward inmate services in Cooper’s proposal.