FEDERAL

Budget and Appropriations

On March 11, President Trump submitted his 2020 budget for the fiscal year beginning October 2019. While this blueprint has limited support from Congress and does not hold the force of law, it does showcase the ongoing priorities of the President and his administration: instituting caps and cuts on the Medicaid program, repealing the Affordable Care Act, as well as significant cuts to food stamps, housing assistance and the Social Security Block Grant among others.

Tax Policy

A bipartisan group of Senators reintroduced legislation (S.651) that will amend the ABLE Act and raise the maximum age of disability onset from “before age 26” to “before age 46.” This would increase the number of eligible ABLE account holders with disabilities and help strengthen state ABLE programs.

Community Living

On February 25, a group of bipartisan lawmakers from the House and Senate reintroduced the EMPOWER Care Act (S.548, H.R.1342), which would extend the Money Follows the Person (MFP) program through 2023. Without an extension, many states will, within months, run out of funds to support transition of qualifying individuals from institutional settings to community living.

Marriage and I/DD

On March 5, Representatives Katko (D-NY) and Keating (D-MA) introduced Marriage Access for People with Special Abilities Act (H.R.1529), which will protect federal benefits, like Supplemental Security Income (SSI), for individuals with intellectual and/or other developmental disabilities (I/DD) who wish to legally marry.  

STATE

Legislative

The Governor’s Budget was released earlier this month. Below are areas that would have a direct impact on people with I/DD. View this webpage for more details.

Money Follows the Person (MFP) Sustainability - Replaces expiring federal receipts to continue support for transitioning individuals with disabilities from inpatient facilities to qualified community settings. This funding shifts seven positions and adds two new positions to provide administration, management, fiscal oversight, technical assistance, and direct support to beneficiaries.

Developmental Disability Innovations Waiver Program - Provides additional low-acuity Innovations Waiver slots for individuals with developmental disabilities who are on the Innovations Waiver waiting list. These additional slots will become available January 2020.

Transitions to Community Living Initiative (TCLI)- Increases funding for the initiative which supports eligible adults with mental illness in transitioning from institutions to community care settings. This funding will provide additional tenancy and peer support services related to the US Department of Justice (DOJ) Olmstead Settlement. While TCLI is focused on adults with mental illness in institutional settings, there are many people in this group who also have I/DD.  

Division of Services for the Blind and Division of Services for the Deaf and Hard of Hearing

State Match for Basic Support Vocational Rehabilitation Grant - Provides state matching funds to support jobs and training for individuals who are blind, deaf/blind, or visually impaired through the Basic Support Vocational Rehabilitation grant. This will allow North Carolina to leverage an additional $600,000 in federal funds.

Division of Vocational Rehabilitation

State Match for Basic Support Vocational Rehabilitation Grant - Provides state matching funds to support jobs and training for individuals with disabilities through the Basic Support Vocational Rehabilitation grant. This will allow North Carolina to leverage an additional $1.9 million in federal funds.

Benefits Counseling - Provides funding to support five benefits counselors for individuals who are blind and/or have other disabilities to support their employment efforts and explain available support services.

Assistive Technologies - Invests state funding to make a robust supply of state-of-the-art adaptive equipment and assistive technologies available to people with disabilities to enable them to live, work and be educated in their communities.

This is the first step in the budgeting process. After the Governor’s Budget is received by the General Assembly, the standard process is for the House to begin their work on the budget and once approved, send to the Senate. The Senate will likely make changes to the budget and approve their version. Any differences between the two are generally settled through a conference committee. Committee meetings have begun with most of the of the focus on educating new legislators, so there is not much public information on the legislative budget at this point.

Policy

Autism Services - The new Medicaid service for children with autism has been approved by the Centers for Medicare and Medicaid Services (CMS). The final step in moving this to implementation is approval of the state policy to support the definition. Clinical Coverage Policy 8F for Research Based- Behavioral Health Treatment is up for Public Comment from 3/14/19 to 4/20/19.

Medicaid Transformation - The Department of Health and Human Services (DHHS) continues to work with the four statewide plans (AmeriHealth Caritas of North Carolina, Blue Cross Blue Shield of North Carolina, United Healthcare of North Carolina and WellCare of North Carolina) and the regional Provider Led Entity (Carolina Complete Care) who were awarded the contracts to operate the Standard Plan. They are working to prepare for the launch which will occur November 2019 in two regions of the state, followed by the remaining four regions in February 2020.

As the Standard Plan rolls out, DHHS is actively working on the Tailored Plan, which will cover people with I/DD who are on Innovations, receiving other state services or on the Registry of Unmet Needs. In addition, historical Medicaid claims data (billing for Medicaid services) will be used to identify individuals with I/DD who may not fall into the above categories. The Behavioral Health Tailored Plan Workgroup is working on eligibility and will develop a policy paper on eligibility, which should come out soon.

Learn more about the Medicaid transformation.