Public Policy (as of September 13, 2022)

STATE

Legislature

As reported in the last Highlights and Hot Topics, the legislature passed a budget adjustment act during the short session. Though there was hope that the adjustment would include Medicaid expansion, it did not come to fruition. However, the Senate passed Expanding Access to Healthcare and the House passed the Rural Health Care and Savings Act. While both proposed to give healthcare coverage to more people in North Carolina who do not qualify for coverage on the healthcare marketplace, there were other differences that could not be resolved between the Senate and House during the short session. Despite the lack of resolve, it appears that both entities agreed that the state needs to expand healthcare coverage. Discussion is expected to continue and the legislature could be called back into session after the fall elections to resume the healthcare dialogue.

The NC legislature will return for the long session in January, 2023. 

Plain Language- The legislature met and made some changes to the state budget.  Advocates hoped the House and Senate would make healthcare more available in NC.  The legislature may come back together later in the fall to continue talking about healthcare expansion 

Transition at Division of Mental Health, Developmental Disability, and Substance Abuse Services (DMHDDSA)

Following the departure of Deepa Avula, former Director of DMHDDSA, Dave Richard has been covering the division with the help of Mark Benton. Richard and Benton are also leading the effort to recruit a new division director as well as a deputy director. They are recruiting these positions simultaneously to ensure a compatible relationship between the selected candidates.  With interviews underway, Richard and Benton  are aiming to identify the new leadership within the next couple of months. 

Plain Language – North Carolina is looking for a new director and deputy director of DMHDDSA. Interviews are happening and they hope to hire soon. 

Tailored Plan 

The Tailored Plan (TP) is expected to begin on December 1, 2022. A key element of this transition is the 1915(i) services which will replace the B(3) services that are currently being utilized by many people with I/DD. The 1915(i) will be submitted to centers for Medicare and Medicaid services after a 10-day comment period. The state’s goal is to have this submitted by the end of September. The public comment period is expected soon. 

Another key component of the TP is the Tailored Plan Care Management (TCM). Notices about the TP and the TCM have been sent out to people with I/DD who are expected to move into the TP. 

The TP Choice Period is August 15, 2022 through October 14, 2022. During the Choice Period, beneficiaries  who qualify for the TP will be able to choose their primary care provider (PCP) and TCM provider.

TP members can choose a PCP or TCM provider by calling the Tailored Plan’s phone number listed in their notice. Members can search and find providers on the NC Medicaid Enrollment Broker’s website.

For questions about this process, contact the enrollment broker.

• Phone: 1-833-870-5500 (TTY: 711 or RelayNC.com)
• Website:  www.ncmedicaidplans.gov

Members who do not choose a PCP or TCM provider will be assigned to one by their TP. 

The Council has received feedback from some individuals and families that the website is difficult to navigate. There are also concerns about whether the network of medical providers and other services, such as physical therapy, is adequate. Some individuals/families are not finding their current doctors or other specialists on the website. The Council has shared these concerns with the state. 

Plain Language – Many people with I/DD will have their supports managed through the Tailored Plan (TP) starting on Dec 1, 2022.  People will get a letter in the mail about choosing a doctor and choosing a care manager. 

FEDERAL

Budget

The Senate Appropriations Committee released drafts of 12 appropriations bills. The Labor, Health and Human Services, Education and Related Agencies (L-HHS-ED) bill included a 20% increase for a total of $216.1 billion. The bill is generally less generous than the House bill in funding some programs related to I/DD. The most significant percentage increases were Lifespan Respite Care Act (73%), State Grants to Remove Barriers to Voting (47%), Individuals with Disabilities Education Act (IDEA), Personnel Preparation (100%), and Parent Information Centers (50%).

Congress had a break during the month of August and will now begin to work out differences between the House and Senate appropriations packages. The federal fiscal year begins October 1, 2022 and it is unlikely that a budget will be agreed upon by then.  Expect to see some stop-gap funding bills to keep funding in place while a budget is worked out. 

Plain Language – Congress is working on a budget for next year. Some of the funding will provide supports and services for people with disabilities. 

Centers for Medicare and Medicaid Services (CMS) 

CMS is proposing a new rule designed to simplify the application and verification processes for people seeking coverage through Medicaid and the Children’s Health Insurance Program known as CHIP. The regulation being published this week would standardize eligibility and enrollment for the programs. The rule would generally limit renewals to once a year, ensure that applicants have 30 days to respond to requests, create consistency in the renewal process across states and mandate that renewal forms be pre-populated. The regulation would eliminate requirements for in-person interviews and impose a 90-day reconsideration period in cases where coverage is terminated because beneficiaries fail to return information needed to determine re-eligibility.

Plain Language – There are some new rules that will make it easier to get approved for Medicaid. This should help people with disabilities.