Read a summary of recent public policy updates that may be of interest to North Carolinians with intellectual and other developmental disabilities (I/DD). These updates are current as of June 23, 2025.

STATE 

Budget

The House budget overall spending is the same as the Senate’s: $32.6 billion in the 2025-26 fiscal year and $33.2 million in the 2026-27 fiscal year. As we know, neither of these budgets included Innovations or TBI slots nor DSP wage increases. There are potential proposed cuts to single stream funding to the MCOs, as well as the elimination of the Healthy Opportunities Program. The proposed cuts to the Governor’s Task Force could affect the successful re-entry program for people with I/DD. Lack of additional funding for Vocational Rehabilitation affects this agency’s ability to pull down needed federal dollars.

While the total spending is the same in the House and Senate proposed budgets, there are several areas of difference between the two budgets. These areas include tax policy and differences in state employee and teacher salaries. Also, the Senate budget proposal includes a Division of Value, Accountability and Efficiency (DAVE) program to be helmed by State Auditor Dave Boliek which is similar to DOGE at the federal level. The House budget does not include this.

In addition, the state is waiting on determining the impact of the federal budget on Medicaid and other programs such as SNAP (food stamps).

A Conference Committee has been appointed to iron out differences, but the House and Senate seem to be far apart in negotiations. It will likely be this Fall before we have a budget.

Bills  

Healthcare Workforce Reforms (H67 - previously H562 Community College Behavioral Health Workforce Act): Includes language that would change qualification requirements for positions related to I/DD services. Changes to requirements for associate professionals and qualified professionals:

• Associate Professional may be a graduate of a community college with an associate degree in a human services field with less than two years of experience with the population served.
• Qualified Professional (QP) may be a graduate of a community college with an associate degree in a human services field and has two years of supervised mental health, developmental disabilities, and substance abuse services experience with the population served.

A QP is currently required to have a four-year degree. This would allow them to have an associate degree in human services from a community college.

Related to this legislation, the NC Community Colleges are partnering with the North Carolina Business Committee for Education (NCBCE) to develop apprenticeships for DSPs and QPs and create more of a career path in this area of employment.

Driver’s License Designation/Autism (HB21): This bill requires the Department of Motor Vehicles to develop a designation of autism on licenses, upon request. This is a voluntary program for people who want to inform officers that they have autism. It also includes training for officers. It passed the House and is in the Senate rules committee.

Since the writing of this policy update, the Senate proposed a mini-budget that would fund the Healthy Opportunities Pilot, you can find more about that here.

 FEDERAL

President's Budget

On May 30, 2025, the President released his budget, which proposes massive cuts to government departments and agencies. The budget proposes a $31.3 billion cut to the U.S. Department of Health and Human Services and a $12 billion cut for federal education programs, including a 36% cut to the Office for Civil Rights in the U.S. Department of Education.

The President’s budget explicitly proposes the elimination of the University Centers for Excellence in Developmental Disabilities (UCEDDs) as they have been categorized as DEI. In North Carolina, the Carolina Institute for Developmental Disabilities serves as our UCEDD. The proposed budget also cuts $1.8 billion for Centers for Medicare and Medicaid Services (CMS).

The President's budget serves as a roadmap for Congress for how the Administration wants Congress to fund the government. Congress does not have to follow the recommendations of the Administration. There is still an opportunity to fight for the programs we care about.

Federal Budget

The House passed a budget bill which would be disastrous for people with disabilities and their families, older adults, and rural communities. The Congressional Budget Office (CBO) estimates that the bill would increase the deficit by $2.4 trillion over a decade and that sixteen million people could lose health insurance if that bill becomes law. In North Carolina it is estimated that over 250,000 people would become uninsured.

The proposed changes to Medicaid include work requirements, co-pays, and increasing re-certification of eligibility to twice a year. These all put administrative burdens on individuals and on the state and local government. It will be an extra cost to states to set up tracking systems to implement these requirements. There are also potential reductions to the federal match that states receive. In NC, a change in match sets off a ‘trigger law’ that would end Medicaid expansion.

There are proposed reductions to the Supplemental Nutrition Assistance Program (SNAP) which provides food to low-income citizens. The proposed budget would shift costs to states from 100% federal to 75% federal which would require NC to fund $700 million. The Senate has suggested less of a cut but would still leave NC with over $300 million to make up for the loss. It is likely that many people will lose access to food if these cuts stand.

Overall, the House bill would require that states change how they finance their programs and states will inevitably be forced to reduce benefits. People will lose health care and other services.

The Senate is working on their version of the budget bill with Senate committees submitting revisions to the House-passed One Big Beautiful Bill Act, shoring up funding for big-ticket items while making further changes to Medicaid, SNAP, student loan options and more.
While the House first proposed the new Medicaid work requirement, it exempted parents with dependents. The Senate’s version broadens the requirement to include parents of children older than 14, as part of their effort to combat waste in the program and push personal responsibility.

Already, the Republicans had proposed expanding work requirements in the Supplemental Nutritional Assistance Program (SNAP) to include older Americans up to age 64 and parents of school-age children older than 10. The House had imposed the requirement on parents of children older than 7. People would need to work 80 hours a month or be engaged in a community service program to qualify.

The Senate also keeps in place the House’s proposed new $35-per-service co-pay imposed on some Medicaid patients who earn more than the poverty line, which is about $32,000 a year for a family of four, with exceptions for some primary, prenatal, pediatric and emergency room care.

The House and Senate will have to come to an agreement on a final budget. There is pressure from the President to have a final budget for signature by July 1, 2025. 

Join NCCDD for its Monthly Policy Education Meeting 

The North Carolina Council on Developmental Disabilities (NCCDD) holds monthly meetings to discuss current policy issues that impact people with intellectual or other developmental disabilities (I/DD). NCCDD supports policies that encourage the integration between people with intellectual or developmental disabilities (I/DD), those who support them, and the community. NCCDD provides this information to educate and inform. We do not lobby on specific legislation.

Join our Public Policy Education Meetings on the second Thursday of every month via Zoom. The meetings are free and open to the public. Join the meeting at this link: https://www.zoomgov.com/meeting/register/vJItdu-uqD8oHpxzFX9FiES_lSmk_8OP4r4#/registration