Public Policy Update (as of 9/23/24)

STATE

Legislature 

HB 10, which was a Conference Committee report, was passed on September 9 by the Senate and passed on September 11 by the House. This bill includes $277 million in recurring funds and $100 million in non-recurring funds to address the Medicaid rebase. (The primary reason for the need for additional funds is that NC’s economy has improved; therefore, the federal match for Medicaid is lower so the state needs to contribute more.)  

DHHS had estimated that $458 million was needed to address Medicaid rebase and this amount was in the Governor’s budget. The total allocated funds in this bill ($377 million) were less than the request from the Department. There is a Medicaid fund that can be accessed if needed but needs legislative approval.  

DHHS had also requested additional money to support Medicaid transformation. This was not addressed in the legislation. There are concerns that this may result in reductions in some areas such as the Healthy Opportunities program.  

The legislation also included increased funds for Opportunity Scholarships (vouchers for private schools). These allocations will increase each year over the next few years and eventually will reach $800 million. The rationale for funding these was that there is a waiting list for the vouchers.  

The bill was sent to the Governor for signature. The Governor vetoed the bill based on objection to the voucher funding. The legislature is scheduled to reconvene on October 9 and the veto will be over-ridden.  

Despite the massive waiting list, what was missing from this bill were funds for Innovations Waiver slots and Direct Support Professional (DSP) wage increases. Our voices are needed as we move into the long session in January.   

DMH/DD/SUS Strategic Plan 

The Division received a good amount of feedback on the Strategic Plan which was reviewed and incorporated into the final version which was posted September 23.   

“The DMH/DD/SUS Strategic Plan for 2024-2029 describes our mission to build systems, services, and supports that improve the well-being of all North Carolinians affected by Mental Health (MH) and Substance Use (SU) challenges, Intellectual/Developmental Disabilities (I/DD), and Traumatic Brain Injury (TBI). It reflects our vision for communities without stigma where all are supported to live healthier and happier lives. It details what we are doing to make this vision a reality for all North Carolinians. It is the plan for our continued transformation.” 

To learn more about the DMH/DD/SUS Strategic Plan for 2024-2029, you can attend an upcoming townhall on October 9, 2024, at 6:00 p.m.  Register here for Our Vision for the Future: Working Together to Transform the Public MH/SU/IDD/TBI System townhall. 

Grants to Address DSP Recruitment and Retention 

DSP Provider Recruitment and Retention Grants are available for community providers. The Division of Health Benefits is offering providers the opportunity to apply for grants to enhance recruitment and retention of DSPs. There was a webinar held earlier this month and several office hours are being offered to answer questions about the grants. Proposals will be accepted through November 8.  

Tailored Care Management 

DHB has developed a Tailored Care Management (TCM) toolkit to address questions and provide information about the TCM services. The toolkit can be found at https://medicaid.ncdhhs.gov/tailored-care-management/toolkit.   

FEDERAL 

After returning to Washington after an extended August break, members of Congress worked through the weekend to draft a bipartisan continuing resolution (CR) that would extend funding for the federal government until December 20 and include minimal needed spending adjustments for certain programs to ensure they receive adequate funding to operate for the duration of the CR. The CR also includes funding for the Secret Service to provide additional security for the presidential and vice-presidential candidates through inauguration in January. Notably, the CR does not include the controversial “SAVE Act,” which mandates that states adopt restrictive identification requirements for individuals registering to vote and which has been a major sticking point in negotiations. 

House Speaker Mike Johnson (R-LA) introduced the measure in the U.S. House of Representatives on September 22 after spending the weekend hashing out the bipartisan agreement with Senate Majority Leader Chuck Schumer (D-NY). A failed House vote last week on Speaker Johnson’s proposed CR, which included the controversial “SAVE Act,” spurred negotiations between Speaker Johnson and Leader Schumer, with both eager to pass a CR by September 30 to avoid a partial government shutdown. 

Speaker Johnson is expected to bring the CR for a vote in the House as early as September 25, with a likely vote in the Senate soon after. 

While Congress is expected to avoid a shutdown, advocates should continue reaching out to their members of Congress not only to finalize a CR, but to enact a final fiscal year (FY) 2025 spending bill that supports people with I/DD.  

Marriage Penalty for SSI Recipients 

Eliminating the Marriage Penalty in SSI Act (EMPSA Act) was introduced in January 2024.  This type of bill has been introduced before but yet to be passed. We may get some help with awareness and advocacy through a movie that is coming out.  

“Patrice: The Movie” had its world premiere last weekend at the Toronto International Film Festival and will debut on Hulu September 30. 

This is another area where continued education and advocacy is needed.