FEDERAL

Budget and Appropriations

President Trump signed a continuing resolution (CR) which fully funded agencies previously impacted by the government shutdown including Agriculture, Housing and Urban Development, the Department of Justice and Transportation through the end of fiscal year 2019. Discussions are already underway for 2020 funding, the first fiscal year that will be impacted by tax cuts passed in December 2018.

North Carolina’s Congressional Delegation

Representative Walter Jones (NC-3) passed away on February 10.  Serving for nearly 25 years, Jones was known for voting independently, strong relationships across party lines, and personally reaching out to his constituents. A special election will need to be called by the Governor, beginning with primary elections of each party.

Last week, after considering several days of testimony centered on mail-in ballot tampering, the North Carolina State Board of Elections unanimously called for a new election to be held in North Carolina's 9th Congregational District. Legislation passed by the NC General Assembly in December of 2018 requires a new primary election as well, leaving 9th district constituents without representation for several more months.

The U.S. Supreme Court announced it will hear two unresolved state cases (North Carolina and Maryland) regarding how Congressional district maps are drawn. This could impact 2020 elections in our state.

Money Follows the Person (MFP)

In late January, President Trump signed a 3-month extension to this very successful federally-funded state grant program focused on transitioning individuals with disabilities from institutional settings into the community.  We anticipate seeing future legislation designed to fund the program for several years. Learn more about MFP in North Carolina here.

Community Living:

In mid-January, the Disability Integration Act (H.R.555, S.117) was reintroduced by Representative Sensenbrenner (R-WI) and Senator Chuck Schumer (D-NY). The legislation would require states to offer community-based living options for individuals who qualify for Medicaid long-term services and supports. It would also require states to address the need for affordable housing.

Employment Legislation:

Senator Casey (D-PA) introduced two employment bills in late January.  The Transformation to Competitive Employment Act (S. 260) will phase out 14(c) subminimum wage certificates (which allow qualified employers to pay individuals with disabilities less the minimum wage often in sheltered workshop-type settings) over six years while at the same time provide grant funding and technical assistance to help states and businesses transition. The Disability Employment Incentives Act (S.255) aims to increase three tax credits designed to help employers hire and retain individuals with disabilities including hiring individuals receiving SSI and SSDI, funding access expenditures, and architectural and transportation barrier removal.

Education:

S.5 would provide a federal tax credit for private school education. H.R. 69, introduced on the same day in early January, would allow parents to take federal funding (Elementary and Secondary Education Act Title I) for public schools to a public or private school of their choice. Note, these bills would not maintain accountability and civil rights protections currently afforded to students with disabilities.

Autism CARES

In early February, Senators Menendez (D-NJ) and Enzi (R-WY) and Representatives Smith (R-NJ) and Doyle (D-PA) introduced the Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2019 (S.427, H.R.1058). This reauthorization legislation funds autism research, surveillance, and education programs.

Social Security Legislation

The Surviving Window(er) Income Fair Treatment Act of 2019 (SWIFT Act, S.345), introduced by a number of Senate Democrats, aims to update provisions and increase benefits for widow(er)s or surviving divorced spouses with disabilities. Find detailed information here.

STATE

Legislative

The NC General Assembly (NC GA) convened on January 9 to appoint leadership and establish committees. Sen. Phil Berger continues as President Pro Tempore for the Senate, and Rep. Tim Moore continues as Speaker of the House. Of particular interest is the I/DD Caucus which will continue this year under the leadership of Rep. Jon Hardister, Rep. Jean Farmer-Butterfield, Sen. Joyce Krawiec, and Sen. Terry Van Duyn.

The NC GA reconvened on January 30 to begin the work of this long session. One of the major tasks is developing and approving a budget for the biennium (July 1, 2019 – June 30, 2021). Once the Governor’s Budget is received, 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. It is more likely than in past that Medicaid expansion could pass, so expect to hear more about that. In addition, increases in Medicaid rates will likely be presented. Areas we hope to see addressed in the budget process include: registry of unmet needs, housing/residential supports, crisis supports, family support (to help address non-clinical social determinants of health), and protection of existing funds in the system.

Medicaid Transformation

Prepaid Health Plan (PHPs) contracts have been awarded for operation of the Standard Plan, which will cover approximately 1.6 million Medicaid recipients across the state. As a reminder, people with I/DD who are on Innovations, receiving state-funded services, or on the registry of unmet needs will not be assigned to the Standard Plan. But there are people with I/DD in our state who will be initially assigned. There were four statewide plans awarded to AmeriHealth Caritas of North Carolina, Blue Cross Blue Shield of North Carolina, United Healthcare of North Carolina, and WellCare of North Carolina. One regional Provider Led Entity (PLE) to cover two regions of the state was awarded to Carolina Complete Care. The following link provides an overview of contract awards. https://files.nc.gov/ncdhhs/medicaid/Medicaid-Factsheets-PHP-2.4.19.pdf

Over the next several weeks, the Department of Health and Human Services (DHHS) will meet with the PHPs to prepare for the launch which will occur November 2019 in two regions of the state, followed by the remaining 4 regions in February 2020. NC Medicaid beneficiaries will begin receiving information in the mail about managed care, plan options, and how to enroll in a plan. The state has contracted with a national group, Maximus, to provide Enrollment Brokers to assist with choosing plans.

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. Areas of attention include: ensuring a robust and knowledgeable network of medical providers, ensuring access to Enrollment Brokers who understand I/DD and our system of supports/services, understanding of navigation/case management as critical system element, identifying the process for moving between Standard Plan and Tailored Plan. The state continues to accept comments and suggestions as they move forward. https://www.ncdhhs.gov/assistance/medicaid-transformation