FEDERAL

Health Care Coverage

Now through December 15, individuals can enroll in the Affordable Care Act.  State-specific options can be found at www.healthcare.gov. Financial assistance may be available for people with low or moderate incomes. Currently enrolled beneficiaries who do not take action will be automatically re-enrolled in the current plan. Re-enrollment is also an important opportunity for people to report any changes in income. You can find enrollment help here.

In Congress, three House committees have approved the Lower Drug Costs Now Act of 2019 (This bill requires the Centers for Medicare and Medicaid Services to negotiate prices on insulin and at least 25 drugs each year for Medicare Advantage and Medicare Part D plans. The bill also creates an out-of-pocket limit of $2,000 for Medicare Part D plans. Low income subsidy recipients would also forgo co-payments on generic medications.

Higher Education

The House Committee on Education and Labor approved the College Affordability Act (H.R. 4674) on October 31. As a comprehensive reauthorization of the Higher Education Act, this bill reauthorizes the Transition and Postsecondary Programs for Students with Intellectual Disabilities (TPSID). It also addresses college affordability in a number of ways including increases to Pell grants, improvements to student loan programs and by providing federal dollars to states offering free community college education. In addition, this legislation requires colleges to accept an existing IEP or 504 plan as evidence of disability when requesting accommodations. More information can be found in the Consortium for Citizens with Disabilities (CCD), of which the National Association of Councils on Developmental Disabilities is a member, Education Task Force Letter.

Respite Care and Direct Support Professionals

November is National Family Caregiver Month, and we’ve seen a focus on caregiving and community living in Congress. On October 31, the Senate Committee on Health, Education, Labor, and Pensions approved the Lifespan Respite Care Program Reauthorization Act of 2019 (S.995). The Lifespan Respite Care Program, which provides federal funds via grants to states, helps strengthen coordinated state lifespan respite systems, helps family caregivers identify and use respite funding sources, encourages community and faith-based partnerships, and trains respite workers and volunteers.

On November 1, The Consortium for Citizens with Disabilities, along with the National Domestic Workers Alliance, hosted a Congressional briefing titled "The Hidden Crisis of Care in the U.S. - Addressing the Homecare Workforce Shortage." The briefing focused heavily on the care shortages and the need for federal-level investment and focus to alleviate strain on families and individuals being served in the community.  Information on  the direct support professional bill, Direct Creation, Advancement, and Retention of Employment (CARE) Opportunity Act (S.2521/H.R.4397), can be found in September’s HHT.

Transportation

The Department of Transportation (DOT) hosted the Access and Mobility for All Summit which provided an opportunity to learn about government efforts to improve accessible transportation and announce new initiatives including The Complete Trip Deployment solicitation which provides $40 million to communities to promote independent mobility and $5 million in cash prizes for inclusive design of automated vehicles.

Supplemental Security Income

On October 30, ten senators reintroduced the Supplemental Security Income (SSI) Restoration Act of 2019 (S.2753). The bill would revise and enhance the SSI program by updating the general earned income disregard to $123 per month, updating the earned income disregard to $399 per month, and updating the resource limits to $10,000 for an individual and $20,000 for a couple. The SSI Restoration Act would repeal SSI's in-kind support and maintenance provisions as well as penalties for resource transfers, marriage, and state tax credits.

STATE

Legislative Budget   

The state continues to operate under last year’s budget. As a reminder, the approved legislative budget was sent to the Governor who vetoed the budget bill because Medicaid expansion was not included. While the House voted to override Gov. Roy Cooper’s June veto of the state budget bill for fiscal years 2020 and 2021; at this point, the Senate has not voted on this because they do not have enough votes for an override.

The budget includes several positive items for people with I/DD including Innovations Waiver slots, increases in some direct support professional wages and a study to expand these increases, and ten-year plan to address the waiting list. In addition, it includes Medicaid Transformation Funds that are needed to move forward with the state’s plan. There are some concerning areas of the budget such as cuts to DHHS funding, continuing reductions to the LME/MCOs, and moving some DHHS offices from Raleigh to Granville County. While all of these items are a part of the discussion/negotiation between the Governor’s office and the General Assembly, the most contentious areas seem to be Medicaid expansion (which is not in the budget) and the amount of allocation for teacher raises.

The legislature reconvened on November 13^th and it appears that the focus will be on Congressional redistricting. While we hope that budget talks will continue, it will likely be January before the budget is addressed.

Medicaid Transformation

Enrollment for the Standard Plan is currently underway. Open enrollment will close statewide Dec. 13, 2019. Letters were sent out to beneficiaries.

• People with intellectual or other developmental disabilities (I/DD) who are in the NC Innovations Waiver should NOT have received a letter
• People who have Medicaid as their health insurer and are using Medicaid b3, state funded (NCTracks), or other Medicaid services (e.g. ABA through Medicaid, Research-Based Behavioral Health Treatment) and are NOT on the Innovations waiver, received a letter indicating options to enroll in a Standard Plan or remain in the Tailored Plan. It is important to know that enrolling in the Standard results in losing access to any services through the LME/MCOs.
• People with I/DD who have Medicaid as their health insurer and are not connected to the LME/MCO received letters their services will be managed by one of the statewide Prepaid Health Plans (PHPs) or the one regional PHP that will offer the Standard Plans. Those individuals will tap into the assistance of the NC Enrollment Broker to choose a plan. (www.ncmedicaidplans.gov;  833-870-5500).  

In the event someone is assigned to a Standard Plan and feels they need to be in Tailored Plan, there is a “Request to Stay” form that can be submitted to request to be in the Tailored Plan.

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 RFP for the Tailored Plan is in the final stages of approval and is scheduled to be released in February. The Behavioral Health/IDD Tailored Plan has a projected launch in July 2021. Learn about the design of the program.  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.

For any questions or comments about Medicaid transformation, emails can be sent to the following address: [email protected]

Redistricting

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 in a process that was much more transparent than in the past and submitted 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.  On October 28, 2019, a three-judge panel of North Carolina’s superior court approved new state legislative district maps.