Public Policy Update - February 2021
FEDERAL
COVID Relief
Both the Senate and House of Representatives approved a budget resolution that creates a path for COVID-19 relief efforts through budget reconciliation. Reconciliation is a special process that allows lawmakers to pass a relief package with only a simple majority. Democrats currently hold the majorities in both the House and Senate, so it is expected that most of President Joe Biden's $1.9 trillion COVID-19 relief package will pass.
The process of budget reconciliation does not allow for policy changes, only changes to funding lines. Currently, the budget resolution includes $9.7 billion for Medicaid Home- and Community-Based Services and includes adult dependents within the recipients of the $1,400 Economic Impact Payments. The process will likely take several weeks as negotiations on details take place. Until it passes, we will not see the legislative language.
This is not the only path to negotiating a COVID-19 relief package. It could still go through the typical legislative process as a bipartisan group of lawmakers are working on a potential COVID-19 package in place of the budget resolution. This approach will require agreement of 60 Senators instead of the 50 Senators needed for budget reconciliation.
The goal is to have something passed by March.
Other Congressional Activities
Lawmakers in both the House of Representatives and the Senate have been busy introducing new legislation and reintroducing legislation from the previous Congress that did not pass. Below are three bills that have been proposed or introduced that could impact people with I/DD. Important to track in the 117th Congress:
COVID-19 Relief
COVID HCBS Relief Act (H.R.525, S.151): a bill to provide an emergency increase in federal funding for state Medicaid Home- and Community-Based Services (HCBS).
All Dependents Count Act: Senator Tina Smith and Representative Angie Craig propose to expand the definition of dependents to include children younger than 19, college students below the age of 24, disabled adults and qualified relatives, ensuring these people are included in economic stimulus payments.
Supporting Children with Disabilities During COVID-19 Act (S.240): a bill to appropriate emergency funding for the Individuals with Disabilities Education Act (IDEA), early childhood education programs, and the Assistive Technology Act of 1998.
STATE UPDATE
Legislative
Both the House and the Senate have standing committees that are focused on public policy areas in order to move legislation. When a bill is introduced in the legislature, it is typically sent to a standing committee. Some of the key standing committees in both the House and Senate with appointed chairs include:
- House Appropriations – Chairs: Rep Dean Arp, Rep Donny Lambeth, Rep Jason Saine
- House Health – Chairs: Rep Kristin Baker, Rep Donny Lambeth, Rep Larry Potts, Rep Wayne Sasser, Rep Donna White. Vice Chairs: Rep Carla Cunningham, Rep Verla Insko
- House Appropriations on Health and Human Services – Chairs: Rep Kristin Baker, Rep Larry Potts, Rep Wayne Sasser, Rep Donna White. Vice Chair: Rep Donny Lambeth
- Senate Appropriations/Base Budget – Chairs: Sen Kathy Harrington, Sen Ralph Hise, Sen Brent Jackson,
- Senate Health Care – Chairs: Sen Jim Burgin, Sen Joyce Krawiec, Sen Jim Perry
- Senate Appropriations on Health and Human Services – Chairs: Sen Jim Burgin, Sen Joyce Krawiec, Sen Jim Perry
Oversight Committees are established by State law for a specific purpose and usually focus on providing oversight of a state agency or policy area. Below are appointed chairs of the ones with most potential impact for I/DD.
- Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services – Chairs: Sen Joyce Krawiec, Rep Donny Lambeth
- Joint Legislative Oversight Committee on Medicaid and NC Health Choice - Chairs: Sen Joyce Krawiec, Rep Donny Lambeth
- Joint Legislative Education Oversight Committee - Chairs: Sen Deanna Ballard, Rep Hugh Blackwell
The Council’s policy team will provide updates on the budget process and pertinent bills, especially those related to the Council’s priority areas for educating policy makers. These include:
- COVID-19 Access
- Registry of unmet needs (RUN)
- Olmstead Planning
- Medicaid Transformation/Tailored Plan
- Direct support professional (DSP) wages
- Housing and Transportation
- Employment First
Bills
Multiple bills have been filed in the early days of the legislative session on a wide variety of issues, but we have not yet seen many that impact people with I/DD.
2020 COVID Relief Bill Modifications – This bill modifies some of the reporting requirements and timelines for several agencies for use of previously allocated funds. For example, it extends the deadline for DPI to use COVID funds for several purposes including emergency nutrition services, mental health services, and student support service programs for at-risk students whose learning has been negatively affected by COVID-19 impacts. This bill passed the Senate, House, and was signed into law by the Governor.
SB 61 - Dental Services/Medicaid Transformation – This bill directs the Department of Health and Human Services (DHHS) to enter into capitated contracts with at least two prepaid dental plans for the provision of dental services to Medicaid and NC Health Choice recipients consistent with the goals of Medicaid transformation. This bill has passed first reading in the Senate.
We will continue to monitor bills as they are filed. There is much interest in both the House and Senate on additional innovations slots.
Medicaid Transformation
Medicaid Transformation continues to move forward. The Standard Plan is scheduled to launch on July 1, 2021. Information on how to enroll in a Medicaid Managed Care health plan will be sent to beneficiaries soon. These integrated managed care products called Standard Plans will cover physical health, behavioral health and pharmacy services. The open enrollment will be from March 15, 2021 through May 15, 2021.
Behavioral Health I/DD Tailored Plans, which is specialized managed care focusing on the needs of individuals with significant behavioral health disorders, intellectual and developmental disabilities (I/DD), and traumatic brain injuries (TBI). These plans are scheduled to begin in July 2022 and will cover a more robust package of Behavioral Health, I/DD and TBI services compared to Standard Plans.
On February 2, DHHS released a memo titled Behavioral Health I/DD Tailored Plan Memo on Eligibility and Enrollment Updates, which clarified the process to identify the people who will not be automatically enrolled in the Standard Plan. Claims and encounters with dates of service since Jan. 1, 2018 will continue to be utilized to identify beneficiaries with Behavioral Health I/DD Tailored Plan qualifying diagnoses and service utilization for purposes of identifying individuals who will be in the Tailored Plan. DHHS has also expanded the list of qualifying I/DD diagnoses included in its claim/encounter data reviews to include some additional types of cerebral palsy, additional genetic disorders, and pervasive developmental disorder.
The Request for Applications deadline for the Tailored Plan was on Feb 2. The LME/MCOs submitted proposals to operate the Tailored Plans. While reviewing the applications, DHHS is in a ‘silent period’ until they award the contracts.