Budget & Appropriations
On September 27, President Trump signed a continuing resolution (CR) to fund the federal government for an additional eight weeks beyond the start of the fiscal year 2020 on October 1. This CR maintains level funding and will give the Senate Appropriations Committee time to finalize its remaining two appropriations bills, including the Labor, Health and Human Services, Education, and Related Agencies Appropriations bill which funds many programs vital to the disability community.
Money Follows the Person
On September 27, the Senate confirmed Eugene Scalia to be Secretary of Labor by a vote of 53-44. The Department of Labor (DOL) is the agency responsible for the implementation of federal labor and employment laws. DOL also includes the Office of Disability Employment Policy, which is a non-regulatory agency that promotes employment of people with disabilities. ODEP’s “Right Talent Right Now” poster, in celebration of National Disability Employment Awareness month, can be found here in English and Spanish.
Autism Cares Act
The Senate passed the Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2019 by a voice vote on September 19. Eleven days later, the Autism CARES Act (H.R.1058) was signed into law by President Trump —a five-year reauthorization.
In addition to continuing funding for important existing efforts like autism research, surveillance and education programs at the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and Health Resources and Services Administration (HRSA), the Autism CARES Act expands its focus to address critical lifespan issues. The reauthorization also increases the minimum number of self-advocates on the Interagency Autism Coordinating Committee (IACC).
Direct Support Professionals
On September 19, a group of democratic House and Senate members introduced the Direct Creation, Advancement, and Retention of Employment (CARE) Opportunity Act (S.2521/H.R.4397). This bill provides grants to 15 entities to develop and implement strategies relating to recruitment, retention and career advancement for direct care workers. (Fact Sheet.)
On September 10, North Carolina’s 3rd and 9th districts held special elections. Republican Greg Murphy, a physician and former Representative in the North Carolina General Assembly, was elected to represent the constituents of North Carolina’s 3rd district. Republican Dan Bishop, an attorney and former State Senator, was elected to the 9th district.
The state continues to operate under last year’s budget. As a reminder, the approved legislative budget was sent to Governor Roy Cooper, who vetoed the budget bill because Medicaid Expansion was not included. While the House voted to override the Governor’s June veto of the state budget bill for fiscal years 2020 and 2021; at this point, the Senate has not taken up the issue for a vote. Despite the budget stalemate, the General Assembly is trying to pass ‘mini budgets’, smaller budget bills, that both parties agree upon.
For example, funding for a new transportation initiative and the community college system were approved. This may be a possible vehicle for moving forward with some of the I/DD allocations, including expanding the Innovations Waivers, that are in the budget. The other critical need for the system is Medicaid Transformation funds to support the transition to managed care.
Enrollment for the Standard Plan is currently underway. Beneficiaries in 27 counties started enrolling on July 15, and enrollment for those in the remaining 73 counties will open on Oct. 14, 2019. Open enrollment will close statewide Dec. 13, 2019.
As you recall, in addition to the four statewide Prepaid Health Plans (AmeriHealth Caritas North Carolina, Inc., Blue Cross and Blue Shield of North Carolina, UnitedHealthcare of North Carolina, Inc., WellCare of North Carolina, Inc.), a regional PHP contract was awarded to Carolina Complete Health, Inc., a provider-led entity. Recently, North Carolina Department of Health and Human Services (DHHS) expanded the regions awarded to Carolina Complete Health, Inc.
In addition to serving regions 3 and 5 in the state, the provider-led health plan will also serve region 4. In addition to counties in regions 3 and 5, Medicaid beneficiaries in the following region 4 counties will now have the option to choose Carolina Complete Health, Inc. as their health plan: Alamance, Caswell, Chatham, Durham, Franklin, Granville, Johnston, Nash, Orange, Person, Vance, Wake, Warren and Wilson.
Tools and resources are available for beneficiaries to learn more about health plan options and have questions answered, including the Medicaid Managed Care enrollment website and the Medicaid Managed Care Call Center (833-870-5500).
Medicaid Managed Care benefits for the Standard Plan are scheduled to begin Feb. 1, 2020. However, the budget stalemate may affect this start date. If there is not an approved budget which includes the funding necessary for the transition to Medicaid managed care by the end of November, the implementation will likely be delayed.
The RFA for the Tailored Plan is in the final stages of approval. The Behavioral Health-I/DD Tailored Plan has a projected launch in July 2021. You can view the design of the program on the website.
The implementation of the Standard Plan creates an opportunity for identifying key elements, such as the development of the provider network and enrollment of beneficiaries, which will be crucial for effective roll-out of the Tailored Plan.
In early September, a panel of three Superior Court judges unanimously struck down 2017 House and Senate maps giving lawmakers two weeks – until Sept. 18 – to draw new districts in “full public view” without the use of election data. The three-judge panel found they used unconstitutional partisan gerrymandering to harm Democrats when they created the 2017 legislative maps. Legislators redrew a total of 21 Senate districts and 56 House districts and submitted them to the court. The plaintiff, Common Cause, objected specifically to five county groupings: Columbus-Pender-Robeson; Forsyth-Yadkin; Cleveland-Gaston; Brunswick-New Hanover; and Guilford.
So, we are once again waiting for a court to either approve legislatively-drawn remedial House and Senate maps or to assign the job to a neutral third-party to correct unconstitutional gerrymandering issues.