August 2021 - Highlights and Hot Topics
Letter from the Executive Director
I write this after just sending out an email canceling the in-person option for our August 2021 Council meeting. I really wanted to meet with our Council members, partners, and friends who were vaccinated and who felt comfortable meeting. I also wanted to celebrate JoAnn Toomey’s retirement in person. Unfortunately, we decided the Delta variant is too contagious and too dangerous to have a large in-person meeting.
I am so exhausted. We are all so exhausted.
For those of us who are vaccinated, it feels as if we did everything we were told to do. Yet, we are going backward rather than forward.
In this frustrating time, we need to find safe alternatives to reach out to one another. “Physical distancing” is necessary for us to stay safe. Still, it is damaging to our mental health.
As I have written in the past, it was hard to move my family from Georgia to North Carolina during the pandemic. My children, like most children, were not allowed to meet other children in person for almost a year.
Similarly, many individuals with intellectual and other developmental disabilities (I/DD) across North Carolina were not able to be with friends and family in person. Then, for a few months, many were able to reunite after getting vaccinated. Now, as the Delta variant spreads, our I/DD community returns to social isolation.
Physical distancing and masking are necessary for our physical health. Still, we have to find ways to connect and care for one another for our emotional and mental health.
We also must get the vaccine (if able)! Getting vaccinated will not just protect ourselves. It will also protect those who cannot receive the vaccine. Also, vaccinations are the only way we can all finally and permanently reunite in person.
Stay safe, and take care of one another!
Talley Wells, Executive Director
Public Policy Update as of August 10
STATE UPDATE
Legislative/Budget
The House released their budget this week and is expected to finish voting on the budget later in the week. The House proposal keeps overall spending in line with the version of the budget the Senate passed in June but makes a variety of changes, including how much to cut taxes and how much to pay workers.
Once the House budget is officially approved, a Conference Committee with leaders from the Senate and House will meet to address differences in the two budgets and come to an agreement on the final budget.
Below are a few highlights from the House budget:
- Innovations Waiver Slots: The House, in agreement with the Senate, adds 1,000 slots for people with disabilities to receive enhanced community services under the Innovations Waiver. Since this part of the budget is the same for both the House and Senate budgets, the number of slots will not change when the Senate and House meet to resolve the differences in their budgets.
There are over 15,000 people on the waiting list, and about 750 people are added each year. There is a need for more than 1,000 slots.
- HCBS Fund: The House budget creates the Home and Community Based Services Fund, which will be funded with state savings that result from the increases in the federal match that was part of the American Rescue Plan. The plan is to transfer money the state will not need to spend out of the General Fund into the new HCBS Fund. These dollars may then be used to strengthen community services through increasing waiver slots, increasing direct care wages and increasing private duty nursing.
This may be a way to create additional innovation slots.
- Direct Care Worker Wages: Like the Senate budget, the House budget includes increasing rates to ICFs (Intermediate Care Facilities) for direct support care workers (DSPs). The House also includes increased rates for home and community based service providers to increase wages for direct care workers who work in the community.
It is good to see the increases in wages cover a broader group of DSPs -- not just those in ICF settings.
- Group Home Stabilization and Transition Initiative: This part of the House budget directs the state to establish new rate models and methods to adequately support residential support needs.
- Increase Funding for Traumatic Brain Injury Services: These additional funds would be used to provide residential services, transportation, respite services, and home modifications.
Medicaid Transformation
As NC moves to a new system called managed care where private insurance companies will start managing care for people who use Medicaid, a big step happened on July 1 when the Standard Plan began. People who are receiving services through a Local Management Entity/Managed Care Organization (LME-MCO) did not move to the Standard Plan because the Standard Plan does not include support services provided through the LME/MCO. These individuals will continue to receive their supports through LME/MCOs and their healthcare through Medicaid Direct. They will move to the Tailored Plan next year.
The Department of Health and Human Services received proposals from the LME/MCOs for operating the Tailored Plans, which are scheduled to begin in July 2022. There was an announcement about which LME/MCOs will be given contracts.
The selection process resulted in all seven of the existing LME/MCOs being chosen to contract to serve as regional Behavioral Health I/DD Tailored Plans:
- Alliance Health
- Eastpointe
- Partners Health Management
- Sandhills Center
- Trillium Health Resources
- Vaya Health
- Cardinal Innovations Healthcare*
*While Cardinal Innovation Healthcare was awarded a contract, it is anticipated they will not operate a Behavioral Health I/DD Tailored Plan at launch due to the consolidation with Vaya Health.
Given additional county requests for disengagement from Cardinal, it is expected that the geographic areas for Behavioral Health I/DD Tailored Plans will be significantly different at launch.
Only entities operating as LME/MCOs were eligible to apply to become Behavioral Health I/DD Tailored Plans. The first Behavioral Health I/DD Tailored Plans contract term will last four years.
NC Spending Plan for Federal Funds
The American Rescue Plan Act of 2021 allows NC Medicaid to receive additional funding for its Home and Community-Based Services (HCBS) programs. NC Medicaid recently submitted its “North Carolina Spending Plan for the Implementation of the American Rescue Plan Act of 2021” to the Centers for Medicare & Medicaid Services (CMS) for review and approval. A few highlights of this proposal include:
- Waiver Expansion & Waitlist Reduction: NC Medicaid is proposing the expansion of waiver slots and reduction of waitlists for four of NC Medicaid’s HCBS programs. This includes the Innovations waiver.
- Home Health Enhancements: Home Health will be expanded beyond the current criteria to include persons who are transitioning from institutions to the community and who have three or more chronic conditions of any type. This effort will enable more people to receive services in the community.
- Expand Research-Based Behavioral Health Treatment (RT-BTH) to provide Autism-specific supports to people over 21. This would expand the current supports that are only available to children.
- Unified Waitlist Project: This would support DHHS efforts in developing a state waitlist that contains up-to-date information on people who are waiting for Innovations slots and other supports.
The NC proposed plan includes items that support priorities of the Council. The state is waiting on CMS for feedback and hopefully approval of these funding proposals.
FEDERAL
Fiscal Year 2022
On July 29, the House passed H.R. 4502, the "minibus" Fiscal Year 2022 (FY 22) appropriation package to fund the Departments of Labor, Health and Human Services, Education, Agriculture, Energy, Interior, Veterans Affairs, Transportation, and Housing and Urban Development, as well as agencies pertaining to rural development, water development, financial services, general government, the environment and military construction. The Senate has not yet acted on FY 22 funding.
Bipartisan Infrastructure
The Senate on Tuesday, August 10, passed the long-anticipated bipartisan infrastructure bill. After several weeks of arduous negotiations between the parties, the final 69-30 vote was definitive, with 19 Republican senators joining their Democratic colleagues in support of the package. It now heads to the House, where Democrats have the votes to pass it quickly. The legislation will cost around $1.2 trillion over eight years, about $550 billion of which is new federal spending, including major priorities for the disability community:
- $39 billion to modernize public transit, upgrade aging infrastructure & make stations accessible.
- $65 billion to ensure access to high-speed internet for all.
Budget Reconciliation
Work continues on the budget reconciliation package that will be used to pass many parts of President Joe Biden's Jobs and Family Plan. Budget Reconciliation is a tool that makes legislation easier to pass in the Senate; a reconciliation bill only needs a simple majority (51) in the Senate.
Less than 24 hours after the Senate approved a bipartisan $1 trillion infrastructure package, 69-30, senators adopted a $3.5 trillion budget blueprint on a 50-49 party-line vote early Wednesday morning, August 11. Lawmakers will now have to write the legislation on items such as expanding Medicare, providing free community college, paid family leave, fighting climate change, and other priorities of President Biden's agenda. Wednesday's vote unlocks the budget reconciliation process that will allow Senate Democrats to pass their package with no Republican votes, but both bills still have to pass in the House.
This legislation includes language around the investment into Home and Community Based Services (HCBS) that will be a part of the Budget Reconciliation process. This funding ($400 billion) in home and community-based services would increase funding to states and create more opportunities for people with intellectual and other developmental disabilities (I/DD) to receive the supports they need to live in the community.
Final Employment and Transition Webinar Set for September 9
The final session for North Carolina Council on Developmental Disabilities (NCCDD) webinar series on Employment and Transition is titled “Putting All the Pieces Together for North Carolina Employment First”. The speaker for this webinar is Allan I. Bergman, subject matter expert for the U.S. Office of Disability Employment Policy, nationally recognized policy and systems change advocate, and parent of two adult daughters living with developmental disabilities.
The September 9 session, starting at 9:30 a.m., will be held via Zoom and you can register here. This is the last presentation in NCCDD’s 10 sessions to educate and inform stakeholders for Employment First, transition professionals, self-advocates and families, job coaching/CRP staff, and MCO staff providing the context and necessary components for a statewide system that provides and sustains integrated employment for all North Carolinians living with a developmental disability, regardless of complexity or needed level of support.
The webinar will include breaks and time for Q&As.
Disability Organizations to Host a Latin(a)(o)(x) Virtual Listening Session Sept 16
Make plans to participate in a virtual listening session with the North Carolina Hispanic/Latin(a)(o)(x) community of individuals with intellectual and other developmental disabilities (I/DD) on Thursday, September 16, from 7 to 8:30 p.m. via Zoom.
Hosted by The Arc of Union/Cabarrus, FSN of Southern Piedmont and NCCDD, the listening sessions want to learn about what is the vision for one’s family's future? What are some of the challenges and barriers to services that families have experienced - mental health, education, behavioral health and medical health? This event aims to facilitate connections and recommendations for building relationships with Hispanic/Latin(a)(o)(x) leaders in North Carolina for future initiatives.
Space is limited. Please register for the September 16 session here.
This session is part of the NCCDDs’ initiative I/DD Latinx Outreach, Webinars and Resources which includes a listening session for members and staff to gather and hear from the NC Hispanic/Latin(a)(o)(x) I/DD community.
The NCCDD was saddened to learn of the recent passing of former longtime member Adonis Brown on July 28, 2021. Adonis served in numerous roles on the Council between 2009 and 2017, including on its Executive Committee. He became a Master Trainer for the State of North Carolina through NCCDD’s Upward to Financial Stability initiative, helping people with I/DD understand how to save money and increase their financial assets. In 2019, he moved to Missouri to serve as the Executive Director of their Statewide Independent Living Council.
Adonis was born in 1955 and graduated from New Bern High School in 1973 before attending Appalachian State University and North Carolina Central University. He graduated from college in 2010 and received a Master of Business Administration from Ashford University in 2013. He married Clementine Kamga Brown in 1997.
Stated former NCCDD Executive Director Holly Riddle, “If you moved in the orbit of the NC Council on Developmental Disabilities (NCCDD), then you knew or knew of this sun, this center of gravity, this force for goodness, kindness and change. Adonis was a big man, but his heart was bigger.”
Former NCCDD Executive Director Chris Egan reflected, “In spending time with Adonis, it was quickly obvious that he was both an excellent student of history from the academic sense while also being a student of life.”
Former NCCDD member Amanda Bergen also remembered Adonis fondly. As a Boy Scout, she said, he showed her family how to advocate for their son to succeed in becoming a Scout. Adonis’s commitment to empowering others continued throughout his life.
View the obituary for Adonis here.
Project ACCESS Vaccination Drive Adds New Locations
More Covid vaccine drives are being planned by the Project ACCESS initiative via Disability Rights NC (DRNC). The group is working to bring vaccines to people with intellectual and other developmental disabilities (I/DD) and their families and caregivers who have not yet been vaccinated against COVID-19.
The vaccine drives will be held at the following locations and dates:
- Danbury, Stokes County - September 16
- King, Stokes County - September 23
These drives are open to individuals ages 12 and up with or without disabilities. Please check DRNC’s website at https://disabilityrightsnc.org/ for more information on specific locations.
