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Public Policy Update - Dec. 2018

Public Policy Update Nov 2018




Voter ID - One of the constitutional amendments that passed in the recent elections 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 legislature convened in November to develop legislation related to voter ID. A voter ID bill (S 824) was passed. The Governor vetoed the bill; however, the veto was overridden in the Senate and overridden in the House. There was extensive work done to alleviate some of the concerns about effects of this bill on people with I/DD. There are multiple ways to obtain free IDs including the DMV and County Board of Elections. There is also a provision to ensure people have access to a Birth Certificate through the Register of Deeds that is free of charge.

If a registered voter shows up to vote without a photo ID and can demonstrate that there is a ‘reasonable impediment’ to obtaining a photo ID, that person can fill out a ‘Reasonable Impediment Declaration Form” and will be allowed to cast a provisional ballot. Reasonable impediments include lack of transportation, disability or illness, lack of birth certificate, work schedule and family responsibilities. The County Board of Elections will review these exceptions.

There is a need now to educate people about the new requirements. NCCDD will work with its partners to develop and distribute information about this new law.

General Assembly - The new year will see the start of the long session of the legislature. During this session, the budget for the next two years will be approved. The North Carolina General Assembly will convene for its long session on January 9, 2019. This will be an organizational day to elect legislative leaders, and the speaker of the House of Representatives and the president pro tempore of the Senate may appoint chairs and members of standing committees, among other household business. The General Assembly will then return Jan. 23 to begin work in earnest and take up new legislation.


Medicaid Transformation - We are in a ‘quiet period’ with the Department of Health and Human Services (DHHS) as they review the proposals which were submitted for operation of the Standard Plan. The contracts will be awarded in February 2019. The following is the timeline after awards are made:

  • Summer 2019. Prepaid Health Plans (PHPs) must have contracted with enough care providers for their network to meet DHHS standards.
  • July 2019. PHPs must have all call centers operational and all relevant staff located in North Carolina.
  • July-September 2019. Managed care will start in two phases. For regions of the state in Phase 1, this will be the window in which beneficiaries select a PHP.
  • November 2019. The Medicaid managed care program will launch in regions in Phase 1.
  • October-December 2019. For regions of the state in Phase 2, this will be the window in which beneficiaries select a PHP.
  • February 2020. The Medicaid managed care program will launch in regions in Phase 2.

As a reminder, individuals with I/DD who receive supports through Innovations Waiver or state funds, as well as people on the Registry of Unmet Needs, will be in the Tailored Plan, which will not be implemented until at least a year following the Standard 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.

Autism Services – The Research-Based Intensive-Behavioral Health Treatment definition was approved by the Centers for Medicare & Medicaid Services (CMS). This allows for Medicaid eligible children (birth – 21) diagnosed with autism spectrum disorder (ASD) to receive services that treat or address ASD. The state Medicaid policy related to this definition is expected to be posted for public comment in the next few weeks.


Supplemental Nutrition Assistance Program Reauthorized
On December 10, the House and Senate conferees released a bipartisan Conference Report on the Agriculture Improvement Act of 2018 (H.R. 2; often referred to as the "Farm Bill"), to reauthorize U.S. farm policies and programs as well as the Supplemental Nutrition Assistance Program (SNAP, also known as food stamps). The bill, which rejected cuts previously proposed by the House, was passed in the Senate by a vote of 87-13 and in the House by a vote of 369-47. Learn more about the importance of SNAP for people with disabilities here.

Money Follows the Person​​
On December 11, the House passed the Improving Medicaid Programs and Opportunities for Eligible Beneficiaries (IMPROVE) Act (H.R.7217) by a vote of 400-11. This bill includes reauthorization of the Money Follows the Person (MFP) program for three months. MFP provides grants to states to transition people from institutions to community-based settings. According to a report from the U.S. Department of Health and Human Services, this program has helped over 63,000 people transition into the community and has saved Medicare and Medicaid almost $1 billion as of 2013. You can find additional information about North Carolina’s specific program here. Additionally, the IMPROVE Act extends Medicaid's spousal impoverishment protections for Home and Community Based Services beneficiaries for three months. The spousal impoverishment protection allows the spouse of a Medicaid Long Term Services and Supports (LTSS) beneficiary to maintain a modest amount of income and resources for food, rent and medication. The next step: Senate must pass this legislation before Congress adjourns for the year.

The Senate put similar language in its continuing resolution to fund the government through February 8. All eyes are on the House and President to see if similar legislations is passed and passes signed by the President.

The Affordable Care Act
On December 14, Federal District Court Judge Reed C. O’Connor ruled that the Affordable Care Act (ACA) is unconstitutional as a result of specific provisions in the Tax Cuts and Jobs Act. The ruling further argued that the entire law was invalid because the provision requiring people to purchase health insurance was unconstitutional. While the decision is likely to be appealed, the law remains in place as the case makes its way through the lengthy judicial process. If the Court’s decision is upheld, its estimated that more than 17 million people would lose health insurance. Many of the law's most popular provisions would end: protections for people with pre-existing conditions, allowing parents to cover their children until age 26, eliminating annual and lifetime limits on coverage, and other provisions.

Budget and Appropriations Deadline
Congress has until midnight on Friday, December 21 to wrap up seven of the 12 outstanding appropriations bills in order to avoid a partial government shutdown. Funding could lapse for the Departments of Justice, Housing and Urban Development, Transportation, and others if a deal is not reached to fund these agencies. If a deal is not reached, affected agencies would develop their own plans detailing which government activities are put on hold and which employees are considered "essential" to continue working.

The Senate has continuing resolution language, funding through February 8, in place. The House is expected to take up the issue, however the President has indicated the possibility of vetoing a funding package that does not include border wall funding.

North Carolina’s 9th Congressional District
On January 11, the North Carolina state board of elections will have a hearing on allegations of election fraud centered in Bladen County. The board of elections can opt to certify the current election results or hold a new election. Some people have speculated about holding a new primary election. After North Carolina certifies a determination, the Speaker of the House in Washington D.C. also has the power to seat or not seat the winner. Until this issue is resolved, residents of the 9th district may contact their Senate offices for constituent support.

Remembering President Bush’s Legacy
This month President George H.W. Bush died at the age of 94. Several news agencies shined a light on his legacy as a champion for disability rights when he signed the Americans with Disabilities Act (ADA) into law. Joe Shapiro, author of No Pity and journalist frequently covering disability issues shared his thoughts. Robin Troutman, Deputy Director of Operations for the National Association of Councils on Developmental Disabilities (NACDD) also shared her thoughts on the passing of President Bush.



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North Carolina Council on Developmental Disabilities
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