FEDERAL

Stimulus Package

The House gave final congressional approval to the American Rescue Plan Act, the third COVID-19 stimulus package, on March 10. President Biden is expected to sign the bill on Friday, March 12. The bill includes funding for $1,400 direct payments to many Americans (including dependents and individuals with disabilities), extension of unemployment benefits, assistance for businesses, state and local governments (including schools and IDEA), expansion of the child tax credit, and funding for vaccines and testing, among other provisions. Also included in the bill is funding for Home and Community Based Services (HCBS) – something that had been hoped for in previous relief packages – which allows states to receive 10% in their federal Medicaid match starting April 1 for one year. These additional funds are required to be used for specific purposes including reducing waiting lists, increasing rates, and addressing provider’s increased costs related to COVID-19. This type of funding is desperately needed in NC to address our waiting list and to keep people in community settings. 

Voting Rights

Last week, the House of Representatives passed the For the People Act (H.R.1) entirely along party lines (220-210). The sweeping measure would require all states to offer mail-in voting and early voting, institute nationwide automatic voter registration, curtail voter ID laws, limit partisan gerrymandering, and overhaul campaign finance laws. The majority of the provisions included in H.R. 1 will positively impact all voters in America, including voters with disabilities. However, the paper ballot mandate included in the bill is of concern to voters with disabilities. The ability to mark, verify, and cast a paper ballot privately and independently is currently not an accessible option for all voters. The bill now heads to the Senate, where it is expected to face opposition. The Senate Rules and Administration Committee will hold a hearing on the For the People Act on Wednesday, March 24, 2021. There can be many barriers to voting for people with disabilities. It is important that any changes to how voting works make it easier, not harder, for people with disabilities to vote.

State Update

General Assembly

The General Assembly is holding committee meetings and we are beginning to see some bills emerge. 

• 2020 COVID Relief Bill Modifications – This bill modifies some of the reporting requirements and timelines for several agencies for use of previously allocated funds. For example, it extends the deadline for DPI to use COVID funds for several purposes including emergency nutrition services, mental health services, and student support service programs for at-risk students whose learning has been negatively affected by COVID-19 impacts.  This bill passed the Senate, House, and was signed into law by the Governor.
• Reduce Regulations To Help Children With Autism (SB103 and HB91). These two bills, one in each chamber, are identical and indicate an intent to pass this legislation. This bill would establish the NC Behavior Analysis Board to oversee the licensure for behavior analysts in NC so they could provide ABA treatment to children with autism under their own license. (Currently they practice under a licensed psychologist). The goal of this legislation is to increase access to autism treatment. 

The committees are hearing updates from staff and state agencies over the next few weeks as they prepare to work on budget priorities. The Governor’s budget is expected to be released soon which signals the official start of the budget process for this long session of the legislature.  After the General Assembly receives the Governor’s budget, the Senate will begin the legislative budget process (although there are already some behind the scenes budget conversations in the Senate leadership).  The Senate will approve a two-year appropriations bill and pass it over to the House where their budget will be approved. A conference committee will be appointed to work out differences. 

One of the education priorities of the NCCDD is to reduce the Innovations Waiver waiting list and there is discussion and interest among legislators about funding additional slots.  We will be following this closely and working with our community partners on this issue. 

Medicaid Transformation

Medicaid Transformation continues to move forward. The Standard Plan is scheduled to launch on July 1, 2021. Letters have been sent to beneficiaries who need to enroll in a plan. These integrated managed care products called Standard Plans will cover physical health, behavioral health and pharmacy services to many North Carolinians who receive their healthcare through Medicaid. The open enrollment is scheduled to run through May 15, 2021. 

People who are currently receiving services through the LME/MCOs or are on the waitlist should not have received a letter. 

• People who currently receive services through the Innovations Waiver, the TBI waiver, or non-Medicaid state funds will continue to receive their services and supports through the current system. They should not enroll in the Standard Plan as none of these services will be provided through the Standard Plan.
• People who are on the waitlist will not be assigned to the Standard Plan, but may choose to enroll in the Standard Plan if they feel some of the offered benefits may be helpful. They will not lose their place on the waitlist and can come back to the Tailored Plan. Again, if they are receiving any services through the LME/MCO, these will not be available in the Standard Plan. 

Behavioral Health I/DD Tailored Plans are specialized managed care focusing on the needs of individuals with significant behavioral health disorders, intellectual and other developmental disabilities (I/DD), and traumatic brain injuries (TBI). These plans are scheduled to begin in July 2022 and will cover a more robust package of Behavioral Health, I/DD and TBI services compared to Standard Plans. The LME/MCOs submitted applications to provide these plans and the Department of Health and Human Services is currently reviewing these applications.