STATE UPDATE (Accurate as of 08/15/2020)

NC General Assembly 

Last month’s “Highlights & Hot Topics” included highlights from the legislative session. There were several bills which included budget items, but there was not a comprehensive budget bill. Through a series of minibudget bills, funds were allocated to the Department of Health and Human Services (DHHS) for Medicaid, for Medicaid transformation, for LME/MCOS to address budget shortfalls, and for intellectual and other developmental disability (I/DD) group homes to address COVID-19. 

Yet, the huge wait list for I/DD services was not addressed in any of the mini-budgets during this session. In addition, cuts to the Department of Transportation included a cut to the Rural Operating Assistance Program (ROAP) that funds transportation in rural areas for elderly people and people with disabilities. The original budget included over $18 million and this was reduced to zero and replaced with $10 million from federal COVID-19 funds.

The legislature will reconvene on September 2 to review revenue numbers, make any needed adjustments, and allocate any additional federal COVID-19 funds. 

The Joint Legislative Oversight Committee on Health and Human Services met on August 11. Secretary Mandy Cohen shared a presentation with the committee on use of federal COVID-19 relief funds across NC. At the end of the presentation, the Secretary identified funding priorities moving forward:

•         Increasing Access to Health Care
•         Supporting NC Providers
•         Expanding Prevention Efforts to Combat COVID-19
•         Supporting Mental Health and Resilience
•         Supporting Rural and Historically Marginalized Populations
•         Prioritizing Early Childhood: Responding to COVID-19 /Addressing Leandro
•         Protecting and Serving Aging Adults
•         Fighting the Opioid Epidemic During COVID-19
•         Serving People with Disabilities Close to Home

The highlighted points represent some overlap with priorities of the Council. Addressing the wait list for Innovations and supporting direct support professionals (DSPs) contributes to community living for people with I/DD. The Leandro v. North Carolina case refers to the Supreme Court ruling that North Carolina has a constitutional obligation to ensure all children have access to a sound basic education. The COVID-19 pandemic has further highlighted disparities and gaps that already existed for children and adults with I/DD; and the Council will seek ways to engage in educating policy makers about these critical issues as we move toward the long session of the legislature which begins in January 2021.

DHHS launches #SCOOP tool 

According to recent data, the number of North Carolinians experiencing feelings of anxiety or depression has tripled in a given week. Kody Kinsley, Deputy Secretary for Behavioral Health and I/DD, announced a new tool to help manage stress and mental health during this time:

        S – Stay connected to family and friends

        C – Show Compassion for yourself and others

        O – Observe your use of substances

        O – Okay to ask for help

        P – Physical activity to improve your mood

In addition to SCOOP, the #Hope4NC hotline is available 24 hours a day, 7 days a week at 855-587-3463.

FEDERAL UPDATE

On May 15, the House passed the HEROES Act - a COVID-19 economic relief bill. Highlights include:

• Provide additional support to states for Medicaid, a program on which people with disabilities rely for services and supports.
• $10-15 billion for Home and Community Based Services (HCBS) across a full year. HCBS services include programs like North Carolina’s Innovations and TBI waivers.
• Expanded COVID-19 related paid sick leave that includes all workers, as well as grandparents and siblings who must leave work to care for adults with disabilities.
• A retroactive $500 to dependents left out of the last stimulus payments.
• Funding for employers to keep furloughed employees on health care plans until January 2021

More recently, the US Senate announced their new package of COVID-19 and economic relief, called the HEALS Act. Highlights include:

• An extension of Federal Unemployment Assistance, at a reduced weekly rate with a plan for UI at 70% of lost wages Oct-Dec. 
• A second $1,200/$500 per dependent stimulus payment which now includes dependents over age 17.  
• Tax credits for unemployment recipients and for companies that retain workers. 
• Support for COVID-19 related testing, contact tracing and vaccines, as well as focus on support for prevention of spread in nursing homes; support for *some* healthcare providers, but no increased Medicaid match or support for home and community–based services for I/DD. 
• $70 billion in education funding, with 1/3 available immediately and the other 2/3 tied to schools reopening (none tied to IDEA).  

The following chart highlights items of interest for the I/DD community and compares the two pieces of legislation:

The stalemate on negotiations on the two plans now appears likely to drag on for weeks, or even into September. In a sign that negotiators won’t reach an agreement anytime soon, most members of Congress have left Washington for the traditional August recess, with a 24-hour notice to return. Key policy differences include the overall cost of the packages, restoration of enhanced federal unemployment benefits ($600 weekly federal benefit from the March CARES Act expired in July), and funding for state and local governments.