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NCARF

Legislative Session 2018 Budget Wrap Up

The North Carolina General Assembly has adjourned its short session and will be back in town again for a special session on November 27th. This year’s short session turned out to be very fast paced lasting only seven weeks. In those seven weeks, multiple bills moved through both chambers, some were vetoed by the Governor and all of those vetoes were over ridden. The new budget year started on July 1.

NCARF continues to work on policy that provides for reduction in administrative burdens to providers and supports people in employment settings across NC. This interim two member organizations presented at the legislative research committee on employment and people with I/DD. NCARF supported the passage of People First Legislation and the special provision on Medicaid assessments for providers.


Budget:

This year’s budget comes in at $23.9 billion dollars. It provides for teacher raises and state employee raises. Teachers will see a 6.5% salary increase up from 6.2% in the previous budget. State employees also received at least a 2% increase with some seeing up to a 4% increase for correctional officers.

Health and Human Services Budget for the intellectual and developmental disability community is a mixed bag for providers and recipients of services in our state. There were some positive special provisions but also some significant funding reductions.


Special Provisions:

  • Special provision language gave providers of services a much need financial and administrative relief by moving IDD providers with national accreditation to a limited risk category for Medicaid provider screening without jeopardizing quality of services or oversight. This special provision helps agency that are nationally accredited. (S99: page 101)


  • The continued crisis with IDD group homes was also addressed in a special provision. The provision directs the Department of Health and Human Services to work with stakeholders to develop a plan for increased use of “in-lieu-of” services as a way to sustain group homes.  (S335): page 12​.  The report is due back to the Joint Legislative Oversight Committees on Medicaid and HHS no later than January 7, 2019.


  • ABLE accounts also had a special provision change to bring our program in line with a federal law passed last year. This change allows for a family to move money from a college savings account to an ABLE account without being assessed a tax penalty. (S99: page 232)


Some important items were funded in this budget including school safety grants and an increase in community alternative program disabled adult personal care rates.

  • $5,500,000 in recurring funding for the CAP/DA program. Providers of CAP/DA services will see a personal care Medicaid rate increase that brings that service in line with last sessions CAP/C increase. This brings the Medicaid rate from $13 to $15. (S335: page 13)
  • Some School Safety recommendations that emerged from the House Committee on School Safety were funded in this year’s budget including: (S99: page 35)
    • Crisis grant funding: $2,000,000 in one time funding through a grant.
    • Mental Health Support Personnel Funding: $10,000,000 in one time funding through a grant.
    • $12,000,000 in recurring funding for grants to public school for school resource officers in elementary and middle schools.
    • $3,000,000 in one time funds for grants to community partners that will address school safety by providing training to help students develop healthy responses to trauma and stress.
    • $3,000,000 in one time funds for grants for safety equipment.


 
Many concerns still exist around services and supports that are funded through single stream dollars and the growing waitlist for Innovation wavier slots. This budget did not include funding for more Innovation slots. 500 news slots came into the system on January 1, 2018 but those were funded in the previous budget.

Single stream funding continues to see reductions. This year a new funding formula was used to assess how reductions would be implemented at each LME/MCO. Please check this link to see how your LME/MCO did. (S99: page 84)

Here is a quick summary:

Nonrecurring reduction: From $54,605,823  to $71,189,458. (page 86 budget document) Additional $17 million reduction.

Recurring reduction: From $36,002,854 to $36,440,895 (page 86 of budget document) Additional $438 thousand.



Legislative Session 2018: Bill Summary
 

The North Carolina General Assembly just wrapped up their 2018 short session. The session last just over seven weeks. Lots of legislation was debated and some made it into law. Here is a review of some important legislation that moved during 2018. The NCGA will return to Raleigh on November 27th.

Proposed Constitutional Amendments

The six Constitutional amendments that will appear on the November ballot for voter consideration are: 

  • Senate Bill 75 Maximum Income Tax Rate of 7% (Amends the North Carolina Constitution to decrease the maximum allowable state income tax from 10% to 7%.  The current North Carolina income tax rate is 5.499%); 
  • Senate Bill 677  Protect Right to Hunt and Fish (Amends the North Carolina Constitution to protect the right to hunt, fish, and harvest wildlife);
  • Senate Bill 814 Judicial Vacancy Sunshine Amendment (Amends the North Carolina Constitution to create a nonpartisan judicial merit commission that will send recommendations for judicial vacancies to the General Assembly.  The General Assembly will review the nominees and provide two names to the Governor to chose from to fill the vacancy);
  • House Bill 551 Strengthening Victims’ Rights (Amends the North Carolina Constitution to provide additional protections and safeguards to victims of crimes.  This legislation is also known as Marsy’s Law);
  • House Bill 913 Bipartisan Ethics and Elections Enforcement (Amends the North Carolina Constitution to establish the Bipartisan Board of Ethics and Elections Enforcements.  The bill also expands legislative authority to make appointments to boards and commissions);
  • House Bill 1092 Require Photo ID to Vote (Amends the Constitution to require photo identification to vote). 

 

Budget Legislation:

This session was unique in the way the budget was released. Instead of each chamber releasing its own budget bill, the House and Senate crafted a compromise budget that was passed through both chambers as a conference report. A conference report cannot be amended. Any needed changes were made in the budget technical corrections bill.
S99: Appropriations Act of 2018
S335: Budget Technical Corrections & Study
 

The following legislation became law during the 2018 short session:

H403: Medicaid and Behavioral Health Modifications

This legislation permits the Department of Health and Human Services to move forward with the creation and implementation of behavioral health/IDD tailored plans. It also clarifies that all prepaid health plans will cover some mental health services, research-based intensive behavioral health treatment, diagnostic assessment services, and Early and Periodic Screening, Diagnosis, and Treatment services. The legislation puts forward a timeline for transformation and clarifies the role of our existing LME/MCO system as we move toward a fully capitated and integrated system of Medicaid.

 

H156: Medicaid PHP Licensure & Transformation Mods

This legislation is part of the process required to move NC Medicaid into a managed care model. he Prepaid Health Plan Licensing Act (PHP Licensing Act). The PHP Licensing Act provides the requirements for obtaining a prepaid health plan license as well as requirements for maintaining that license.

 

H967: Telemedicine Policy

This bill was changed in committee. The first bill filed at the start of session focused on expanding opportunities for telehealth provides as listed in Chapter 90 of the North Carolina General Statutes. The bill that passed this session is a study that requires the Department of Health and Human Services to report on requirements for insurance reimbursement of telemedicine. Included in that report will be a broadband policy to ensure all North Carolina residents have access to telemedicine, standards for assessing the quality of telemedical care, and licensing requirements for telemedicine providers.

 

H512: Monitor Implementation of TBI Waiver

House Bill 512 requires the Department of Health and Human Services (Department) to make quarterly reports on the status and implementation of the 1915(c) waiver for individuals with traumatic brain injury (TBI). The Department would also be required to adopt rules or medical coverage policies relating to service programs for individuals with TBI, develop a best practice model and strive to maintain adequate reimbursement rates.

 

S768: People First Language 2018

This legislation represents the efforts of champions in the House and Senate and self advocates is removing the “R” word from our state statutes. This effort began in 2009 with the passage of the first People First Language bill that directed legislative drafting staff and the importance of using People First Drafting. This type of drafting refers to a person with a disability as a person first, does not equate a person with the person's disability, and seeks to avoid derogatory language when describing a person's disability. This bill changes "mental retardation" to "intellectual disability" and "the mentally retarded" to "individuals with an intellectual disability".

 

 

Other bills of interest:

The following legislation passed the House but was not taken up by the Senate. All of these bills were part of the Legislative Research Commission on Intellectual and Developmental Disability Employment.

 

H982: IDD Data Sharing/Longitudinal Data System

This bill would create a task force to study the collection and use of data on education and employment outcomes for individuals with intellectual and development disabilities ("IDD") through the North Carolina Longitudinal Data System ("Data System").

 

H983: ABLE Act Changes/Study

The federal government last year passed legislation making changes to federal ABLE law. This legislation puts the federal changes into our state program by allowing funds from a Parental Savings Trust Fund to rollover to an ABLE (Achieving a Better Life Experience) account without the funds being treated as income. The bill language was included in the budget. (Please see the budget summary).

 

H984: Oversight IDD Employment/Educ. Programs

This bill would have created a Director of Education and Employment Opportunities for Individuals with Intellectual and Developmental Disabilities position in the Department of Health and Human Services and appropriate funds for the position; add the Director to the Council on Developmental Disabilities and the Council on Educational Services for Exceptional Children; and require a report to the Joint Legislative Education Oversight Committee and the Joint Legislative Oversight Committee on Health and Human Services by March 1, 2019.  The funding for this position was not included in the budget.

 

The following bill was part of the House School Safety Committee.

 

H934: Threat Assessment Teams

This legislation was a recommendation from the House Select Committee on School Safety. The bill established a treat assessment team model for public schools as well as codifying the NC Carolina Center for Safer Schools and its responsibilities. The bill did pass the House but did not move in the Senate.

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LEGISLATIVE UPDATES

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LEGISLATIVE UPDATES FROM JULIA ADAMS-SCHRURICH