STATE UPDATE (Accurate as of 09/15/2020)

NC General Assembly 

On September 2, the North Carolina General Assembly (NCGA) returned to Raleigh for a two-day mini-session. It is expected to be the last time the General Assembly meets this year, unless there are additional federal funds that need to be allocated. 

The purpose of the recent two-day session was to allocate more than $900 million in federal Coronavirus dollars. The Coronavirus Relief Act 3.0 outlines the distribution of the COVID-19 relief funds to various state departments, universities and nonprofits.  The allocations that are most related to people with intellectual and other developmental disabilities (I/DD) include: 

• Department of Health and Human Services/Department of Social Services - $20 million to provide temporary financial assistance in the form of a monthly payment to facilities licensed to accept State-County Special Assistance (SA) in order to offset the increased costs of serving SA residents during the COVID-19 emergency. The amount of the monthly payment is $250/month/SA resident for the period commencing August 1, 2020, and ending December 30, 2020.
• NC Department of Public Instruction - $22 million to the Department of Public Instruction to award as grants to public school units that apply for funds to provide access to services for exceptional children who have lost critical services as a result of school closures related to COVID-19. Of these funds, the Department is encouraged to use at least $17 million for in-person services for qualifying children. 
• UNC Board of Governors - $6.5 million to the Board of Governors of the University of North Carolina to be allocated to the State Education Assistance Authority to be used to provide scholarships as an alternative educational option for certain students with disabilities during the COVID-19 pandemic. 
• Division of Mental Health/Developmental Disabilities/Substance Abuse Services (MH/DD/SAS) - $38 million for an additional lump sum allocation of single-stream funds to the LME/MCOs. The LME/MCOs are prohibited from using these funds for any purpose other than to provide eligible individuals direct services associated with the COVID-19 pandemic.

Additional Allocations from the Coronavirus Relief Act 3.0 include:

• Extra Credit Grant Program – $440,541,000 from the Coronavirus Relief Fund is allocated to the Department of Revenue to finance an “Extra Credit” grant program. The only criteria for receiving a grant is that the individual/family filed a 2019 tax return on or before October 15, indicating they were State residents for all of 2019 and reporting they had at least one child eligible for the federal child tax credit. These individuals will receive this grant automatically. The amount of the grant is $335 per family. Those households with eligible children, but who did not file state taxes because they did not meet the gross income requirements may apply directly for the $335 in funds.
• Business Grants – $60.5 Million (up from $15 Million) to the Department of Commerce for the Job Retention Grant Program.
• Department of Public Instruction - $21 million to improve Internet connectivity for students in response to COVID-19, by providing community and home mobile Internet access points. These funds shall be used only for the purchase of devices and not for subscription services. 
• Unemployment Benefits -  $87 Million in additional unemployment assistance for the remainder of 2020 in response to the Coronavirus pandemic. This will amount to a $50/week increased benefit amount for individuals receiving State unemployment assistance. The increased benefit amount is payable for weeks beginning on or after September 5, 2020.

Medicaid Clinical Coverage Policies

There are/were numerous proposed new or amended Medicaid clinical coverage policies up for review on the DHHS website. There were several that included addition of telehealth options for services and supports. NCCDD provided comments on the following policies: 

• Clinical Coverage Policy 8A-2: Facility-Based Crisis Service for Children and Adolescents  
• Clinical Coverage Policy 8E: Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)  
• Clinical Coverage Policy 8F: Research-Based Behavioral Health Treatment (RB-BHT) for Autism Spectrum Disorder (ASD) 
• Clinical Coverage Policy 8-J: Children’s Developmental Service Agencies (CDSAs) 
• Clinical Coverage Policy 10C: Outpatient Specialized Therapies, Local Education Agencies (LEAs) 

The above policies included the addition of telehealth options for delivery of services. The pandemic has generated expansion of telehealth in a short span of time to provide services in a safe manner and has offered a unique opportunity to provide alternatives to in-person services. These alternatives have allowed many individuals and families to continue to receive needed supports. As the state moves forward and considers how telehealth will continue to be an aspect of services delivery, it is important to develop methods to evaluate the effectiveness of telehealth for people with I/DD in accessing healthcare and support services. It will be critical to determine which visits and services are effective through telehealth and which are more appropriate for in-person due to urgency, complexity or individual factors. Assessing access to technology, comfort with using technology and cultural acceptance of virtual/remote services is also necessary. While telehealth has certainly expanded access for a segment of people with I/DD, it is critical to ensure that it does not create or exacerbate access issues and result in less effective supports for others with I/DD. 

NCCDD asked that DHHS work with the LME/MCOs to develop a consistent method for evaluating access and appropriateness of telehealth services across the state for people with I/DD. 

NCCDD will also provide input on the NC Innovations Waiver. 

Voting

The November elections are fast approaching. Some key dates to keep in mind:

Oct 9 – Voter Registration deadline

Oct 15 – Early Voting begins

Oct 27 – Last day to request absentee ballot. (Do this as soon as possible because absentee ballots have to be postmarked by Election Day at 5 pm AND received by Nov 6th in order to be counted)

Oct 31 - Early Voting ends

Nov 3 – Election Day

Multi Partisan Assistance teams (MAT) are available in each county to provide assistance with mail-in absentee voting and other services to voters living in facilities and voters with disabilities. Contact your county board of elections to request MAT assistance. They can provide the following help:

•     Providing voter registration services
•     Requesting an absentee ballot
•     Serving as an absentee witness
•     Marking the absentee ballot
•     Sealing the ballot and completing the absentee application
•     Mailing the voted absentee ballot in the closest U.S. mail depository or mailbox, if the voter has a disability

https://www.ncsbe.gov/voting/help-voters-disabilities

https://www.accessthevotenc.org

FEDERAL UPDATE

In our last Highlights and Hot Topics issue, the HEROES Act which was passed by the House and the HEALS Act which was introduced by the Senate were described and compared. Unfortunately, there has been little progress made in the negotiations on a fourth coronavirus relief package. Upon returning to Washington last week, Senate Majority Leader Mitch McConnell (R-KY) introduced a $497 billion COVID-19 relief act. Considered a ‘skinny’ version of the $1 trillion HEALS Act, the Delivering Immediate Relief to America’s Families, Schools, and Small Businesses Act (S.Amdt.2652) was voted down 52-47 along party lines, with Senator Rand Paul (R-KY) who joined Democrats in voting no.

The continued partisan disagreement over the scope of relief needed to address COVID-19 makes it increasingly unlikely that a standalone COVID-19 relief package will pass before the November election. Both chambers are expected to turn their attention to funding the government past the end of the fiscal year on September 30.