Read a summary of recent public policy updates that may be of interest to North Carolinians with intellectual and other developmental disabilities (I/DD). This update is from August 18, 2026, and covers updates from the federal and state level on public policy that is of interest to the intellectual and developmental disabilities community.
FEDERAL
Budget
The federal budget process stalled after the House passed only three appropriations bills out of the 12 that came out of committees. And on the Senate side, there was no progress on the budget due to no agreement on the total budget number. To avoid a government shutdown at the end of September, both the House and Senate passed measures to extend the current budget into December. The week of July 20th, the House passed a stopgap measure that would fund federal agencies at existing levels through December 4, 2026. It was unclear whether the Senate would move on this before recess, but in early August the Senate passed its own Stop Gap bill that extends funding through December 11, 2026. Since the two measures are not the same, the House and Senate will have to reconcile the differences. The House returns on August 31, 2026, and the Senate returns on September 14, 2026, and will need to come to an agreement before the current federal funding expires on September 30, 2026.
CMS Launches New State Toolkit to Protect Children with Autism, Strengthen Oversight of Applied Behavior Analysis Services
The Centers for Medicare & Medicaid Services (CMS) has released a new toolkit to help state Medicaid agencies improve oversight of Applied Behavior Analysis (ABA) services for children with autism while ensuring access to high-quality, medically necessary care. The guidance responds to rapid growth in Medicaid spending on ABA services, concerns about fraud and overutilization, and the need to protect children receiving treatment.
The toolkit provides guidance on:
- Clinical standards
- Design of ABA benefits
- Payment and utilization standards
- Provider qualifications/ credentialing
- Identification of fraud
In North Carolina, there were recent revisions to the Research-Based – Behavioral Health Treatment (RB-BHT), which is the Medicaid funding that supports ABA. These revisions incorporate most of the CMS toolkit guidelines and are more stringent in some areas.
Airline Disability Rules
Regulations finalized under the previous administration that would expand the rights of people with disabilities are being delayed for a second time. The current administration has held off on enforcing these rules, and federal officials are considering rewriting them.
The 2024 rule:
- Requires training for airline staff and contractors who help people with disabilities or who handle wheelchairs.
- Creates standards for how assistance must be provided, specifying that it be “safe and dignified.”
- Outlines the steps airlines must take if a wheelchair is damaged or delayed.
The regulation was supposed to start taking effect in January 2025. Now, the Transportation Department is extending its “enforcement discretion” until April 30, 2027.
STATE
Budget
As reported last month, a state budget was approved in July and includes funding for Medicaid rebase, restarts the Healthy Opportunities program, increases rates for personal care services, and provides money to increase pay for Innovations Waiver Direct Support Professionals (DSPs). There is ongoing discussion around whether the increases also apply to DSPs who provide supports through 1915i funding.
Merger of LME/MCOs
Vaya Health and Partners Health Management are merging to form Vaya Partners, effective October 1, 2026. This union, which was announced back in April, creates North Carolina's largest Local Management Entity/Managed Care Organization (LME/MCO), serving over 222,000 members across 47 counties for mental health, intellectual/developmental disabilities, and traumatic brain injury services. The effective date for the merger is October 1, 2026. The state and leadership from Vaya and Partners are actively engaged in work to create a smooth transition with no disruption of services.