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Public Policy Update - November 2020

STATE UPDATE (Accurate as of 11/12/2020)

Election Results

US Senate Seats: Thom Tillis retained his seat. NC’s two Senators continue to be Sen.Thom Tillis and Sen. Richard Burr.

US Representatives: NC has 13 seats. Prior to the election, there were nine republicans and three democrats representing NC (there was one vacant seat).  Post-election, there are eight republicans and five democrats with three newly elected officials joining NC’s representatives.

At the Congressional level, Democrats retain control of the House. The Senate, which has been under Republican control, is unsure as Georgia has two Senate seats that are headed to a run-off election in January.

There was very little change in the makeup of the NC General Assembly. Senate Leader Phil Berger and House Speaker Tim Moore both were re-elected so there will be no change in the leadership. .  In the Senate, the Democrats appear to have a gain of one seat leaving the balance of 28 Republicans and 22 Democrats; but the Senate race in New Hanover has not been called yet. In the House, the Republicans appear to have added four seats leaving the balance of 69 Republicans and 51 Democrats; but there are three races that have yet to be called.  Regardless of the outcome of these races, the Republicans will retain the majority in both the House and Senate, but do not have a supermajority.  Without a supermajority, the legislature is not able to override any Governor vetoes. With the re-election of Governor Roy Cooper, NC continues to have a divided state government.


The wait for an additional federal relief package to address the pandemic continues. The Senate is back in session, talks about another relief package have re-started with a goal of passing a bill by the end of the year. However, the same barrier remains – how much to spend.  There has been disagreement between the Senate and House on the amount of the package which is likely to remain a roadblock. 

In regards to the federal budget, the Senate released appropriations bills on Nov. 10 in preparation for negotiations with the House.  Congress must enact another spending measure before the current continuing resolution expires on Dec. 11, 2020. (A continuing resolution continues the pre-existing appropriations at the same levels as the previous fiscal year). By Dec. 11, they will either pass an omnibus spending bill or another continuing resolution.

State Legislature

The General Assembly will be back in session on January 13, 2020. This is a long session to develop a two-year budget. The decrease in revenue due to the pandemic will obviously be a factor in the budget process.  Without additional federal stimulus funds, NC and other states will be dealing with significant shortfalls in their budgets.

While there are unknowns about the budget, the Council will continue to educate about the need to address the Registry of Unmet Needs (RUN), to restore transportation funds that were cut last year, and to address Direct Support Professionals’ pay and workforce issues. 

Medicaid Transformation

The state is actively moving forward with Medicaid Transformation and the Standard Plans are anticipated to go live on July 1, 2021.  The Department of Health and Human Services has re-engaged with the Prepaid Health Plans (PHPs) to move the process forward.  The Tailored Plan, which will serve people with intellectual and other developmental disabilities (I/DD) who are receiving Innovations, b(3) services, state-funded services, or are on the Registry of Unmet Needs, is scheduled to launch July 1, 2022.  The RFA from the state is planned to be released this month. As a reminder, the only entities that are able to bid on the Tailored Plan are the current LME/MCOs.

Letters should go out soon to Medicaid beneficiaries across the state. There are two types of letters that will be sent. One letter will instruct someone to enroll in a Standard Plan which will provide integrated physical health and behavioral health. If the beneficiary believes they should be in the Tailored Plan due to significant mental health needs, severe substance use disorder, or needs related to I/DD, they can request to be in the Tailored Plan.

A second letter will state that the beneficiary will stay in Medicaid Direct (the current fee-for-service structure) for physical health and continue to receive supports through the LME/MCO until the Tailored Plans launch in 2022. The beneficiary may opt to enroll in the Standard Plan, but it is important to know that Innovations and other state funded services cannot be provided in the Standard Plan. If the beneficiary is on the Registry of Unmet Needs and opts to go to the Standard Plan, they will not ‘lose their place’ on the list. If they are offered a waiver slot or other services, they would have to come back to the Tailored Plan to receive those services.


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North Carolina Council on Developmental Disabilities
820 South Boylan Avenue
Raleigh, NC  27603
919-527-6500 (voice/tdd)
800-357-6916 (voice/tdd)
800-357-6916 (TTY)
919-850-2915 fax