Statement of the North Carolina Council on Developmental Disabilities Executive Committee on the Impact of the One Big Beautiful Bill
The North Carolina Council on Developmental Disabilities (NCCDD) is deeply concerned about the impact the "One Big Beautiful Bill" will have on the developmental disability (“DD”) community and many others across our state and country. The North Carolina DD community was already in crisis, with nearly 20,000 on the Innovations Waiver waiting list and a Direct Support Professional (DSP) workforce shortage due to low wages. The inability to access Home and Community Based Services had already put many in our community at risk.
The limitations on provider taxes, State Directed Payments, and the implementation of a work requirement system will put enormous financial pressure on NC Medicaid at a time when the list of critical needs is growing every day and state revenues are shrinking. These new limitations and requirements will make eliminating the Innovations Waiver waiting list and raising DSP pay even more difficult. It will further limit the ability of those with DD to access healthcare, particularly in our rural communities.
NCCDD is also concerned for the future of SNAP, a program many in the community rely on for daily meals. The "One Big Beautiful Bill" will require the state to set aside a significant amount of money to pay cost sharing penalties. In North Carolina, the cost sharing penalties are so large it will blow a gigantic annual hole in the state’s budget. This brings into question the funding implications of other programs and North Carolina's continued participation in SNAP.
NCCDD played a significant role over the past 6 months educating federal and state lawmakers regarding the needs of the community. This advocacy included the Council sending a team to Capitol Hill for over half a dozen meetings with Congressional Staff, district meetings with Members of Congress, and constant contact with state officials. That advocacy, and the advocacy of countless other partners, is reflected in what was not included in the final bill. We deeply thank everyone who took the time to talk to us.
While North Carolina's DD community has made significant progress in the past few years with the introduction of 1915(i), Tailored Plans, increasing DSP wages, and competitive integrated employment. It is imperative that the gains and momentum achieved by the community not be lost or slowed. We once again underscore the two critical needs – the Innovations Waiver Waitlist and DSP wages – that have substantially worsened over the last decade. NCCDD will continue its work advocating and working with federal and state leaders on both sides of the aisle to mitigate the impact on the DD community and helping to identify ways to tackle unaddressed critical needs. We recognize that our work is much harder now, but our community is always overcoming obstacles and thriving through setbacks. Our work continues!
Jonathan D’Angelo, Chair
Marjorie Serralles-Russell, Vice-Chair
Donna Spears, Vice-Chair
Bethany Dawn Smith, Secretary
Tony Hall, Finanical Asset Development Committee Chair
Charlrean Mapson, D. Min., Community Living Committee Chair
July 9, 2025
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