FEDERAL (Accurate as of 06/15/2020)

Legislative

In Congress, the House passed the HEROES Act, which is the fourth COVID-19 bill. The HEROES Act is a massive $3 trillion proposal, even more ambitious than the $2.2-trillion CARES Act. This relief legislation promises a second stimulus check, debt relief, student loan forgiveness, hazard pay, six more months of COVID-19 unemployment, housing and food assistance, and nearly $1 trillion in aid for state and local governments so they can pay “vital workers like first responders, health workers, and teachers” who are at risk of losing their jobs due to budget shortfalls.

The Senate is not eager to take up this new coronavirus legislation, arguing that Congress needs to assess the impact of other stimulus bills on the country. Leadership has stated that they do not expect to pass another round of relief legislation until later in July.

Areas we would like to see directly addressed in the next legislation include:

• Funding for home and community based services 
• Identification of direct support professionals as essential workers so they would be eligible for any increased wages or benefits in the next legislation
• Access to Personal Protective Equipment for direct support professionals
• Ensure that any incentive payments include all people with disabilities, including those who are claimed as dependents. 

Policy

The U.S Department of Health and Human Services’ Office (HHS) for Civil Rights said Tuesday it reached a resolution with the state of Connecticut in a first-of-its-kind complaint filed by disability advocates. The complaint alleged that the state’s policies related to hospital visitors during the COVID-19 pandemic violated the Americans with Disabilities Act, Section 504 of the Rehabilitation Act and the Affordable Care Act. As part of the resolution with the HHS Office for Civil Rights, Connecticut is issuing an executive order creating a new statewide policy requiring that people with disabilities be allowed to have a designated support person with them at the hospital. Disability advocates said that while the resolution is specific to Connecticut, its significance extends beyond the state. Hopefully this can serve as a model for other states. 

As part of the federal coronavirus relief bills earlier in the year, a $175 billion the Public Health and Social Services Emergency Fund was established. There have been delays in releasing these dollars for the benefit of Medicaid beneficiaries. The Administration announced recently that it is sending billions of dollars in aid to disability providers and others funded by Medicaid who have been impacted by the pandemic. The U.S. Department of Health and Human Services said this week that some $15 billion will go toward providers serving individuals covered by Medicaid and the Children’s Health Insurance Program, including home- and community-based services providers.

Federal Bills to Follow

SNAP Online Purchasing Flexibility Act of 2020, H.R. 6510  - This bill directs the Department of Agriculture to authorize all states to participate in the Supplemental Nutrition Assistance Program (SNAP, formerly known as the food stamp program) online purchasing program during the COVID-19 (i.e., Coronavirus disease 2019) public health emergency. The program allows approved retail food stores to accept SNAP benefits through online transactions.

Food Assistance for Kids and Families During COVID-19 Act of 2020, S. 3563 - This bill would provide authorization and funding for grocery delivery services via SNAP. 

Both of the above bills would allow people with disabilities to utilize their SNAP benefits while protecting themselves and their families in this time of crisis.

Strengthening UI for Coronavirus Impacted Workers and Students Act, H.R.6680 - This bill would make several improvements to unemployment insurance (UI) benefits, including exempting them from income for all means-tested programs. This would allow people with disabilities to receive UI benefits without complicating eligibility for Supplemental Security Income (SSI) or the Supplemental Nutrition Insurance Program (SNAP).

STATE

Legislative

Since May 18, the North Carolina General Assembly has been in short session, has introduced multiple bills, and continues to examine COVID issues, budget issues, and other needs. A comprehensive budget is unlikely this session. Instead, a series of ‘mini-budgets’ to address critical budget needs has been introduced. Below you will find legislation and bills related to intellectual or other developmental disabilities (I/DD). 

Legislation Passed:

H1169 – Bipartisan Election Act of 2020 – addresses the ability to vote by absentee ballot. By requiring only one witness signature and allowing for an online ballot request process, it is intended to make voting easier as we head into election season in the midst of the COVID-19 pandemic. 

S476 – School Based Mental Health - Requires the state board of education to adopt a school-based mental health policy and to require K-12 school units to adopt and to implement a school-based mental health plan that includes a mental health training program and a suicide risk referral protocol.

Bills still following:

H488 – Address Direct Support Personnel Staffing Crisis – this bill funds the salary increases for International Classification of Functioning (ICF) Direct Support Professionals (DSPs) to match the salaries of DSPs in state facilities. It also includes funds to conduct a study of rates paid to DSPs providing innovations services. (This bill was filed in late March and seems to have stalled at this point, but hopefully it might be included in one of the mini-budgets.)

H1149 - Police Notice of Person with I/DD in Vehicle – directs the Division of Motor Vehicles to develop a designation for drivers’ licenses that may be granted upon request to a person with I/DD. There is significant opposition to this bill and concern about having this information stored within the DMV database with potential for discrimination in renewal of licenses.

H1181 - Certain Appropriations For Education/COVID – allocates funds to educational entities to address issues related to COVID-19.  It includes $25 million to the Department of Public Instruction for grants to public schools to address COVID related costs for students with disabilities.  

H1196 - Funds/COVID-19 Tests & Personal Protective Equipment (PPE) for Congregate Living allocates $12 million from the Coronavirus Relief Funds to conduct testing for staff in congregate living settings and distribute Personal Protective Equipment to congregate living settings. 

H1173 – Disapprove Certain DHHS Rules – this bill proposes to disapprove a list of rules that have already been approved by the Rules Review Commission. One of the rules is related to screening and care for people with I/DD in jail settings, which was a set of rules that had been vetted and approved by several I/DD entities and seen as a positive step in addressing issues in jails. There continues to be opposition to this bill in the I/DD community. This bill has been pulled but it may come up again.  

S730 – No Patient Left Alone Act – addresses the visitation rights of hospital patients to have someone present while receiving hospital care. 

S808 – Medicaid Funding Act – includes appropriations for several purposes including funds for moving Department of Health and Human Services (DHHS) offices from the Dix Campus, COVID relief funds for behavioral health and crisis services, funds for Medicaid, and Medicaid Transformation reserve funds. This bill also makes changes to the methods related to medicaid savings in LME/MCOs. It also delays implementation of the Standard Plan to July 2021.

S834 – Close the Medicaid Coverage Gap – proposes another approach for filling the health insurance coverage gap (sometimes referred to as Medicaid expansion). This bill only covers single adults up to 133% of poverty, instead of all those in the gap, but does so without the work requirements.

You can review the status of each bill by searching the bill numbers at https://www.ncleg.gov/BillLookUp/

Policy

The Department of Health and Human Services continues to address COVID-19 through use of waivers described in the May Highlight and Hot Topics. Recently, additions to Appendix K, which allowed flexibility for the Innovations and Traumatic Brain Injury waiver, were approved by CMS.  Some of the additional flexibilities include: relatives and legally responsible persons may provide services for more than one 90 day period, primary Alternative Family Living (AFL) providers may provide Supported Employment, Day Supports, and Community Networking, the requirement for Letter of Medical Necessity/prescription for Assistive Technology is temporarily waived. 

Below are links to resources for COVID-19:  

•       NC Council on Developmental Disabilities COVID-19 resource page
•       NC COVID-19 page
•       CDC COVID-19 page
•       Hope4NC Hotline for mental health resources 24/7: 1-855-587-3463
•       Hope4Healers Helpline for care professionals 24/7: 919-226-2002