The Behavioral Intervention Guidelines Act of 2021 (S.1383/H.R.2877) is under consideration in the Senate following its passage by the House by a vote of 323-93 on May 13, 2021. The bill would require the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop best practices for schools to establish behavioral intervention teams and properly train them on how to intervene and avoid inappropriate use of mental health assessments and law enforcement. Voices in the civil rights and disabilities communities have shared concerns related to the growing research that documents the biases that are often part of behavioral evaluations and the risk of interventions linked to the justice system.
This bill will ask parts of the federal government to work together to work on tools that they hope will help to prevent violence in schools. There are concerns that assessments could be used unfairly to affect students with disabilities.
There continue to be discussions on what to include in recovery and infrastructure legislation. Priorities in the disability community that are being considered as part of the legislative packages include:
There are opportunities within this large bill for helping people with disabilities. The list above aligns with the Council’s priorities.
The U.S. Equal Employment Opportunity Commission (EEOC) has provided updated and expanded technical assistance guidance: What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws. This guidance answers questions arising under the federal equal employment opportunity (EEO) laws including expanded answers on how the ADA and the Genetic Information Nondiscrimination Act (GINA) apply when employers offer incentives for proof of vaccination or require vaccinations for employees. In addition, a new resource addresses things like harassment, high risk of getting sick, not being allowed to work, and modification of employer safety requirements.
This guidance provides information to people with disabilities who are worried about discrimination at work because of COVID or vaccines. People can learn more about how laws protect them. Employment is priority for the Council and this guidance supports this priority.
Budget – The House and the Senate have agreed on the total budget amount but there does not seem to be agreement on priorities within the budgets. The House and Senate continue to work on details of their proposed budgets but it seems unlikely that there will be an approved budget by the end of June. This has happened many times in the past, and without an approved budget, the state will continue to operate on the previous year’s budget until a new one is approved.
We continue to track several bills:
HB 247 Standards of Student Conduct – This bill directs public school boards to develop discipline policies and would remove part of an existing law that describes violations that ARE NOT considered a serious violation of conduct including “inappropriate or disrespectful language, noncompliance with a staff directive, dress code violations, and minor physical altercations that do not involve weapons or injury.”
There is concern that this bill would allow schools to easily suspend or expel students for non-serious violations and that it would unfairly affect students with disabilities. This bill passed the House and has been referred to the Rules Committee in the Senate. Advocates continue to provide input and express their concerns.
HB 249 Children with Disabilities Funding Formula – H249 would direct the Department of Public Instruction to study the funding formula for children with disabilities and special education in public schools and consider a model that would base funding on the severity of disability. The bill also increases the cap on the current funding formula for children with disabilities from 12.75% to 13%. The study report would be due to legislative education committees by February 15, 2022.
The funding formula for special education has been a concern for a long time. A plan to address this could improve education supports for children with I/DD. This bill was referred to House Appropriations and we are hopeful it may show up in the budget.
HB 914 Support Our Direct Care Workforce – This bill would provide a rate increase to certain Medicaid providers for services related to the provision of direct care. Includes providers of waiver services, personal care services, ICF/IDD group homes. It also mandates that providers use at least 80% of funding resulting from the rate increase to increase the wages paid to its direct care employees.
Direct Support Professional (DSP) pay is a priority for the Council. This bill would provide higher wages for DSPs. This bill was heard in the House Health Committee and has been referred to House Appropriations and we are hopeful it will show up in the budget.
North Carolina Innovations Waiver Act of 2021 – Bills were filed in the House (H389) and Senate (S350) that would fund an additional 1000 Innovations Home and Community-Based Waiver slots including 200 set aside for the development of a tiered waiver to support people with a lower level of need. The bill also requires NC DHHS to convene a stakeholder group to develop a ten-year plan to address the registry of unmet needs, aka those waiting for services.
While these bills did not pass the Senate and House, they were both heard in committees and referred to Appropriations. It is hoped that funding for 1000 Innovations waiver slots will be in the budget.
S103/H91 - Reduce Regulations To Help Children with Autism: This bill will allow behavior analysts to obtain NC licensure and provide services on their own. Both the House and Senate passed this bill and it was signed into law by the Governor.
This legislation will increase access to early intervention for children with autism. It has been signed into law.
HB 642 - Down Syndrome Organ Transplant Nondiscrimination Act
The bill is not Down syndrome specific even though that is in the title. This bill prohibits discrimination in the organ transplant process on the basis of mental or physical disability including I/DD.
This bill ensures access to needed medical care. It has passed both the Senate and the House and will become law.
Other State News
Vaya and Cardinal LME-MCOs are merging. This comes after several counties made the decision to leave Cardinal which left Cardinal with too few counties to support operations. At this time, it seems that Stanley, Forsyth and Cabarrus counties will move to Partners LME-MCO. Orange and Mecklenburg counties will move to Alliance LME-MCO. The remaining Cardinal counties will likely merge with Vaya. The Department of Health and Human Services (DHHS) has been working closely with Vaya and Cardinal to work through the details. The goal is to make sure people with disabilities continue to receive services and supports through this transition.
As North Carolina moves to a new system called managed care where private insurance companies will start managing care for people who use Medicaid, a big step happens on July 1 when the Standard Plan will begin. Most people who are receiving services through an LME-MCO will not move to the Standard Plan because the Standard Plan does not include support services provided through the LME-MCOs. They will continue to receive their supports through LME-MCOs and their healthcare through Medicaid Direct. They will move to the Tailored Plan next year.
During this transition, there were about 7,000 people who are receiving services through the LME-MCOs (and eligible for the Tailored Plan) who chose to enroll in the Standard Plan. This would make them ineligible for services they are currently receiving or may be able to receive in the future. To ensure that people were fully informed about this choice, DHHS will not move these folks to the Standard Plan on July 1. DHHS will provide additional information to ensure that these beneficiaries are fully aware of services that may be lost if they move to a Standard Plan. This will include a notice to be sent later this month informing them of the change back to NC Medicaid Direct as well as a detailed list of services that are not available in a Standard Plan. They will still have the option to move to the Standard Plan at a later date if they choose to do so.