LEGISLATIVE

The November elections resulted in the Republicans losing the supermajority in both the House and Senate. While the Republicans still have the majority, they no longer have the supermajority which is defined by having 3/5th of the seats. The supermajority is significant because it is the margin necessary to override gubernatorial vetoes. This change may create more opportunity for bi-partisan negotiation and compromise.

One of the constitutional amendments that passed was the voter ID amendment which read, "Voters offering to vote in person shall present photographic identification before voting. The General Assembly shall enact general laws governing the requirements of such photographic identification, which may include exceptions.” The concern that some had with this amendment was that it contained no implementing legislation. So, the concept of "Voter ID" was approved without specifics about what it would look like in practice. The legislature is coming back for a Special Session on November 27th and legislation outlining the specifics is expected. The Council’s concern is that people with disabilities are more likely to not have a photo ID, so we will be monitoring the development of this legislation.

STATE

Medicaid Transformation
As highlighted in the last issue, Requests for Proposals for Operations of the Standard Plan for Medicaid went out. Proposals have now been received by the Department of Health and Human Services (DHHS). Proposals came from the following:

• Aetna
• AmeriHealth Caritas North Carolina
• BCBS NC-Healthy Blue
• Carolina Complete Health (provider-led group under the N.C. Medical Society)
• My Health by Health Providers (provider-led network of 12 N.C. hospital systems)
• Optima Health
• UnitedHealth Care
• WellCare Health Plans

As a reminder, the plan is to have four statewide plans and up to 12 regional plans. DHHS will make a decision on the proposals in February 2019.

There is on-going work, through a DHHS internal workgroup, on the Tailored Plan which will serve people with I/DD, serious mental health issues and serious substance use disorders. Our understanding is that individuals with I/DD who are currently receiving supports through Innovations or state-funded services and those who are on the Registry of Unmet Needs will be assigned to the Tailored Plan. Services include: behavioral health, physical health, I/DD services, TBI services, Long Term Supports and Services and pharmacy. The plan also includes a specialized health home model to ensure strong care management for people in Tailored Plans. This plan will not go into effect until a year after the implementation of the Standard Plan.

There continues to be an opportunity to provide input about the Tailored Plan.

Public Comment on Innovations Waiver - Deadline is 11/22

The North Carolina Department of Health and Human Services, NC Medicaid Division of Health Benefits is seeking the public's comments on the Innovations 1915(c) Waiver. Comments on the waiver may be submitted by email or voicemail from October 23, 2018 - November 22, 2018. The North Carolina Innovations Waiver is a means of funding services and supports for people with intellectual and other related developmental disabilities that are at risk for institutional care in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID). NC Innovations is authorized by a Medicaid Home and Community-Based Services (HCBS) Waiver granted by the Centers for Medicare and Medicaid Services (CMS) under Section 1915 (c) of the Social Security Act.

Email: [email protected]

Phone: 919.855.4968

Note: Requests for copies of the Innovations 1915(c) Waiver can be made via email or voicemail.

FEDERAL

Each election we see just how much every vote counts. Election night may have been November 6th, but votes continue to be tallied in several tight races across the country. While some seats have yet to be certified, it appears the Republican party will retain leadership of the US Senate and Democrats will now control the US House. Looking at North Carolina’s delegation for the upcoming 116th Congress, very little has changed. Senators Burr and Tillis were not up for reelection this year. In the House, incumbents held their seats in all, but the 9th District where Mark Harris prevailed over fellow Republican Representative Pittenger. What North Carolina’s Congressional districts will look like in the future remains uncertain, however. Current Congressional maps were deemed unconstitutional by a panel of federal judges, and cannot be used after the 2018 election. This ruling has been appealed to the Supreme Court.

The current 115th Congress returns for a “lame duck session.” While many priorities exist for both parties and the President, funding for many parts of the government will expire in early December without a continuing resolution. Money Follows the Person state grants require reauthorization to continue funding, and several key programs including the Supplemental Nutrition Assistance Program (SNAP, often referred to as food stamps) wait as the House and Senate try to reconcile competing visions.