Legislative Update

October 3, 2019

Welcome to October! This week the North Carolina General Assembly returned to Raleigh after a week long recess. The week started with a House appropriations committee to take up the first of what will be a series of mini-budgets. The first one this week was the critical funding needed to support Raise the Age legislation. You can read more about Raise the Age at this website.

What To Expect Next Week:
Next week we expect to see the House and Senate have voting sessions on Tuesday, Wednesday and Thursday. Most likely we will see a new series of mini-budgets that address noncontroversial funding priorities.

Budget Update:
A quick look back, the 2019 budget was passed by both the House and Senate on June 27th and Governor Roy Cooper vetoed it on June 28th. Before we had a brief recess, the House completed its override of H966: Appropriation Act of 2019. The bill is now in the Senate. Senator Phil Berger held a press conference this week to lay out the Senate’s plan for the next few weeks. The plan includes taking up a series of mini-budgets, taking votes on key legislation that both chambers have been conferencing on including the Farm Act of 2019 and a goal to wrap up work by October 31. Senator Berger also stated that there is still a possibility for a special session to discuss Medicaid Expansion in NC. If the Senate does decide to vote for a budget override, it will be announced prior to being placed on the calendar.

Here is a quick recap of what the budget includes for the I/DD community:

  • Group Home Bridge Funding: This funding of $1.8 million for FY 2019-2020 continue to provide short term financial assistance in the form of monthly payments to people living in group homes who meet the existing criteria for these funds.

  • Innovation Waiver Slots: The budget funds 1000 new Innovation waiver slots. The first 500 slots will become available on January 1, 2020 and the second 500 will open up on January 1, 2021. There is also a new funding allocation system for some of those slots.

  • IDD Study: Special provision language in this budget address the need for a stakeholder group to design a 10 year plan to look at all aspects of services for people with IDD and their families including addressing the waitlist.

  • Wage Study for Direct Support Professional/Innovation Waiver: Budget provides $200,000 (non-recurring) to support an actuarial analysis of the State’s Innovation Waiver Program to determine how to align wages paid to community based personnel with the wages paid to State employees. The Division of Health Benefits must report by March 1, 2020 the plan and recommendation to the Joint Legislative Oversight Committee on Medicaid.

  • ICF/IDD Group Home Rate Increases: The provides $5,495,000 recurring funding for FY 2019-2020 and $10,995,000 for FY 2020-2021 to adjust the per member per month capitation rate to the LME/MCOs to provide an increase in wages paid to direct support personnel working in community-based ICF/IDD group homes.

The budget also includes funding for Medicaid Transformation:

  • Medicaid Transformation: Funds Medicaid transformation with $242 million for FY 2019-2020 and $56 million for FY 2020-2021. This includes funding to address NC Fast preparedness and upgrades.

DHHS Updates: Tailored Plan:

The Department of Health and Human Services has updated more information regarding the proposed Tailored Plan. The following information is related to the Advanced Medical Home Plus Practices and Care Management. This information includes requests for a State of Interest from providers.  We encourage you to review this information and provide feedback.

Non-binding Statement of Interest for Potential Advanced Medical Home Plus Practices and Care Management Agencies: As forecasted in Tailored Care Management webinar on August 29, this document is an opportunity for provider organizations interested in becoming AMH+s or CMAs to register that interest with the Department. As the Department continues to work on program planning for Tailored Care Management, it would like to begin to model the expected capacity for provider-based Tailored Care Management across the state. Therefore, we strongly encourage you to complete the Statement of Interest form and submit to kelsi.knick@dhhs.nc.gov by October 10.  The form is also an opportunity for you to submit further questions for the Department. 

Please note that public comment period for the Data Strategy for Tailored Care Management is due by October 10, 2019. North Carolina's Data Strategy for Tailored Care Management - Released Sept. 12, 2019. Please send comments to Medicaid.Transformation@dhhs.nc.gov through Oct. 10, 2019.

NC Health News:

In private, and increasingly in public, some are making their support for House Bill 655, which would allow for Medicaid expansion in North Carolina, in defiance of the state party leaders.
By Rose Hoban

Dale Wiggins thinks it’s time. Actually, he thinks it’s past due.

Wiggins, a retired businessman, is the head of the Graham County Board of Commissioners, which recently sent a resolution of support for expanding the state’s Medicaid program to legislative leaders and Gov. Roy Cooper.

Medicaid Expansion Remains A Primary Sticking Point In North Carolina Budget Stalemate-KHN News Round Up.

North Carolina's Republican-led state legislature plans to adjourn by Oct. 31, with or without an approved budget. Earlier in the summer, Gov. Roy Cooper vetoed a budget bill, in part because it did not include Medicaid expansion. In Florida, state Medicaid officials recommend cuts to its program for people with disabilities, though the caps were not as severe as some had initially feared. And in other state budget news, Michigan Gov. Gretchen Whitmer defends her line-item vetoes.

NC News Round Up:

Republicans, Cooper again pitch favored NC budget results

By GARY D. ROBERTSON October 1, 2019

RALEIGH, N.C. (AP) — North Carolina Republican
legislators and Democrats led by Gov. Roy Cooper tried on Tuesday to bring renewed energy toward resolving a summer budget stalemate that’s drifted into fall. But their hoped-for outcomes remain different.

Adjournment Possibilities

On Tuesday, Senate leader Phil Berger, R-Rockingham, told members of the media that he intends to adjourn the Senate "no later than" Oct. 31. House Speaker Tim Moore, R-Cleveland, did not commit to any potential adjournment date. Instead, in an emailed statement to the Insider, Moore said: "Right now, approving the capital infrastructure funds for K-12 schools, universities, and community colleges currently blocked by the budget veto are of the utmost importance, and must be approved as stand-alone appropriations if necessary before adjourning for any significant period of time." Moore also noted that the House is reviewing the "pipeline of priority bills" that need to be passed before they adjourn. (Lauren Horsch, THE INSIDER, 10/02/19)



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