Letter from the Executive Director
2021 comes to a close on the heels of the passing of the North Carolina (NC) budget that was passed and signed into law by Governor Roy Cooper just before Thanksgiving. It contained many important and exciting provisions for the intellectual and other developmental disabilities (I/DD) community.
The new budget includes 1,000 slots for the Innovations Waiver, funds intended to increase direct support professional pay to $15.00 an hour, and some additional funds that can be divided between Community Alternatives Program for Disabled Adults (CAP-DA), Traumatic Brain Injury (TBI), and Innovations Waivers. The General Assembly has also requested reports on the Direct Support Professionals (DSP) workforce and the potential to add another 1,000 slots in the next biennium (two-year session). You can read about these and other provisions in our Public Policy Updates.
While this is exciting, NC still has a waiting list of over 15,000 individuals waiting for services and help. That number grew by more than 1,000 in the last two years.
Next year, the state will move from (b)(3) services to 1915(i) services. (B)(3) services provide a limited array of services to a limited number of individuals with I/DD. The change to 1915(i), which is a different federal code section, will allow everyone with I/DD and Medicaid who qualifies to receive them. That said, the state is going to discontinue some services that were offered in (b)(3). All of us need to stay informed of these changes and advocate and educate.
Still more changes will take place as the state moves to Tailored Plans for individuals with I/DD on Medicaid. This is another important issue on which we need to stay informed and educated and for which we need to advocate. What will care management really be like under the Tailored Plans for individuals on the waiting list and for individuals on the Innovations Waiver? How will peers and family member peers be part of care management?
There will be many more opportunities to educate and advocate through Council initiatives, including our new four-year Registry of Unmet Needs initiative. Let's get ready to stay informed, educate, and advocate. In the meantime, let's celebrate the new year!
Talley Wells, Executive Director
Public Policy Update as of December 13
STATE UPDATE
Legislative
The General Assembly passed a state budget for the fiscal year July 2021 – June 2022, and it was signed into law by Governor Cooper on November 18. This budget includes more items related to people with I/DD than other budgets in recent history. Below are highlights:
This budget is a good start in addressing priorities of the North Carolina Council on Developmental Disabilities (NCCDD) such as the wait list and Direct Support Professionals’ wages.
Thank your legislator for their support this session. We will continue to educate policymakers about how these and other changes are needed to achieve the goal of community living for all people with I/DD.
Managed Care Transformation Update
Tailored Plan implementation, which was scheduled for July 2022, has been delayed until December 2022. The delay in the state budget, along with the on-going work on Care Management and the 1915(i) benefit, played into the decision for the needed delay. Both Care Management and 1915(i) supports need to be ready at the same time as the Tailored Care launch.
Care Management, which is included as a benefit in the Tailored Plan, requires a “multidisciplinary care team to provide whole-person care management that addresses all of their needs, spanning: physical health, behavioral health, I/DD, TBI, pharmacy, long-term services and supports (LTSS) and unmet health-related resource needs.”
The DHHS has created a Tailored Care Management Technical Assistance Group (TAG) to provide input into how this service should be developed and delivered, and NCCDD has representation on this group. For more information, click here for the Tailored Care Management TAG webpage.
NC continues its work on developing a State Plan HCBS benefit. The plan is to transition the current (b)(3) services (such as community living, respite, supported employment) into 1915(i). The state is in the process of developing policies around eligibility, services provided, and any limitations. This is important because it would allow Medicaid-eligible people to access community supports without being on the Innovations Waiver.
FEDERAL
At the federal level, there have been two major funding bills that have been discussed over the past several months: Infrastructure and Build Back Better. As reported last month, Congress passed the $1.2 trillion Infrastructure bill. Key parts of the bill include:
Congress continues to work on legislation as part of the budget reconciliation, or Build Back Better Agenda, that could greatly affect the lives of people with disabilities and their families. We have focused on the HCBS funds, which are critical. There are also many other aspects of Build Back Better (described below) which could have a positive impact for people with disabilities.
HCBS
Education and Child Care
Housing
Paid Leave
Child Tax Credit
Earned Income Tax Credit (EITC)
Supplemental Security Income (SSI) Reforms
Health Care
Closes the Medicaid coverage gap for four million uninsured people by extending affordable Marketplace coverage through 2025 to low-income people in non-expansion states.
Other Disability Policy Proposals
Discussion is on-going, and there is disagreement on some items, including paid leave. While there is an expressed desire to vote on this before the holidays, discussion seems to be extending into next week, which will make it difficult to get a vote through before the end of the year.
NCCDD Hosts Self-Advocate Discussion Series: January and February Sessions
NCCDD is hosting its last two webinars of the Self-Advocate Discussion Series in January and February. The virtual discussion series is facilitated by Chris Hendricks, NCCDD Policy Education Coordinator/Legislative Liaison, and NCCDD self-advocate Executive Committee member Cheryl Powell.
January 5, 1:00 p.m. - Extra Session: Why Do You Participate in the Discussion Series Sessions?
In this bonus session, attendees will describe their experiences of self-advocacy and advocating for others. Facilitators will seek volunteers from the participant attendees to briefly describe different ways of using one’s voice to advocate.
Come ready to share stories about speaking up, speaking to groups, writing and speaking to decision-makers, calling representatives, and making video messages! Register here via Zoom.
February 2, 1:00 p.m. - The Valuable Principle: Policy and Social Change Advocacy
This session is the last in the Self-Advocate Discussion Series. It will begin with policy experts relating the Valuable Principle to building and maintaining relationships with NC legislators and policymakers. Facilitators will seek volunteers from the participant attendees to briefly share knowledge on approaching decision-makers. Register here via Zoom.
The goal of the series is to prepare, organize, and mobilize NC self-advocates for influencing social and systems change. The Council aims to emphasize the value of people with disabilities to build and maintain relationships with NC legislators and decision makers.
New Council Member Spotlight: Tony Hall
NC Governor Roy Cooper has announced the appointment of Tony Hall to NCCDD.
A Raleigh resident, Hall currently works part time for The Arc of the Triangle, where he is a job coach for individuals with I/DD, providing direct support to them in their place of employment and assisting them in accomplishing specific employment and social goals.
Born with spina bifida, Hall attended Pennsylvania College of Technology in Williamsport, Pennsylvania where he earned a Bachelor of Science Degree in Web and Applications Development with minors in Business Administration and Sociology.
“I believe the best thing the Council is doing is addressing the financial needs of the disabled community through all the efforts they are making to provide employment avenues, savings/investment opportunities, and education. This is an important area to address because poverty is a massive issue for a large portion of the disabled community. Addressing this area will greatly improve the lives of these individuals and their families,” Hall said.