Legislative Update

May 15, 2019


Legislative Update:

A lot happening at the North Carolina General Assembly this month. The NC House has passed its budget and we have gotten through crossover. Let’s first talk crossover, this is the date when a bill must pass from one chamber to the other in order to continue its journey through the legislature. It works likes this, a House bill has pass a floor vote and move to the Senate and a Senate bill has to pass a floor vote and move to the House. One big exception is if the bill requires funding in which case it does not need to make the crossover deadline, we call these bills appropriation bills. Also bills with fees attached do not need to make the crossover deadline either an example of these bills would be a licensure bill.

Now let’s talk NC House budget, the 2019-2021 budget comes in at 23.9 billion dollars and passed the House on a party line vote, 61-54. The Health and Human Service budget does include funding for 150 Innovation waivers as well as funding several programs to address critical needs for people with intellectual and developmental disabilities. The budget also provides funding for some mental health and substance use disorder programs.

The April Surprise was a significant announcement highlighting an increase in State collected revenue of $700 million dollars.  This update on the North Carolina’s general fund came after the House had finished its budget process. The question is how does that additional $700 million impact the Senate budget process. We may know that answer soon, the Senate begins its budget process this week with an expected rollout of their priorities by June 1.

Here is the link to the
budget funding report and the Special Provisions. Some key budget highlights can be found in the next few sections along with information on where to find the Special Provision language that give more detail on the funding item.

Budget:

Education Budget
The House Education budget provided $19,000,000 in nonrecurring funding for FY2019-2020 and $30,200,000 non-recurring for FY2020-2021 to support school based mental health support personnel grants and another $2,000,000  in FY 2019-2020 and $4,600,000 in FY 2020-2021 to allow for LEAs to contract with community partners to provide evidence-based crisis services to students. These recommendations for funding came from the report by the House Select Committee on School Safety.

Health and Human Services:

Innovation Waiver Slots:
Funds an additional 150 new slots for people with intellectual and developmental disabilities.
FY 2019-2020: $1,087,020  FY2020-2021: $3,261,060. Special provision language can be found on page 151.

Intermediate Care Facilities “In Lieu of” Services:
This funding is to provide additional services for Medicaid beneficiaries with IDD who are moving from an ICF into a community-based supported living setting.
FY 2019-2020: $11,585,870 Recurring. FY 2020-2021: $11,451,050 Recurring.

ICF/IDD Group Home Wage Increase: Address Group Home Direct Support Personnel Staffing Crisis
Recognizing the need to increase wages paid to direct support personnel working in IDD/ICF group homes this funding would increase the capitation rates to the LME/MCOs effective January 1, 2020.
FY 2019-2020: $5,500,000 Recurring. FY 2020-2021: $11,000,000 Recurring. The accompanying Special Provision language can be found on page 151.

Wage Study for Innovations Waiver Program:
Recognizing the need to determine how to move Innovation waiver direct support personnel wages to be in line with State employee wages at our State-owned developmental centers, the House budget funds an actuarial analysis and wage study of the North Carolina Innovations waiver. The analysis and study must be completed before the next LME/MCO rate negotiation cycle but no later than January 15, 2020. The Division of Health Benefits will conduct the study and report its finding to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice and Fiscal Research Division by January 15, 2020. FY 2019-2020: Nonrecurring appropriation of $250,000. (Special Provision page 151)

Single Stream Funding
This budget does not have a significant reduction to single stream funding. Previous budgets did include both recurring and nonrecurring reductions. This year the reduction was $262,728 per fiscal year of the biennial budget. More information on the distribution of previous reductions to the LME/MCO system can be found in Special Provision language that redistributes the 2017 reductions. (Single-Stream Funding for MH/DD/SAS Community Services: page 161)

Group Home Stabilization Efforts:
Recognizing the continuing need to stabilize group home options the budget provides two separate funding items.



Group Home Funding: Supplemental Short-Term Assistance for Group Homes
Provides $8,000,000 in nonrecurring funding to provide temporary, short term assistance in the form of a monthly payment to residents who meet specific criteria. This funding is for fiscal year 2019-2020. In 2020-2021 a new funding options will be created under a Medicaid service. (See next item) (Special Provision: Supplemental Short-Term Assistance for Group Homes page 165)

Group Home Stabilization and Transition Funding:
$23,000,000 in nonrecurring funding will be used to incentivize LME/MCOs to develop and implement a new “in lieu of” service or other Medicaid-funded service to support the residential needs of Medicaid recipients living in licensed, community-based group homes. This funding will establish a new rate model and rate methodologies to replace the currently inadequate and insufficient State-funded rates. This more appropriate and sustainable models will be implemented by January 1, 2021. (Special Provision: Group Home Stabilization and Transition Initiative page 166)

 

Substance Abuse Services
Provides an additional $5,000,000 non-recurring for each year of the biennial budget to increase substance use treatment and recovery options and to help prevent and reduce prescription opioid misuse.

Children’s Mental Health Services Funds
Provides an increase to the federal Mental Health Block Grant for mental health services to children that treat, empower and support NC children and adolescents with mental illness and families due to increased availability.FY 2019-2021: $1,954,480 recurring.

Electronic Visit Verification System:
To meet our federal law requirements on EVV, the budget provides funding to comply with the requirement as it impacts Personal Care Services or other home-and-community based care. An RFP will be issued by DHHS for an EVV provider. FY 2019-2020 $1,400,000 Recurring. FY 2020-2021 $1,500,000 Recurring.

Special Provisions:
Establish a Workgroup to Reduce Administrative Duplication for Mental Health, Developmental Disabilities, and Substance Use Disorder Providers.
This special provision is identical to the language from H471 which passed the House on a unanimous vote. This special provision requires the Secretary of DHHS to establish a workgroup to examine current administrative requirements for MH/DD/SAS and how best to integrate these with similar requirements for physical health providers to avoid duplication and enhance efficiency. (Special Provision Page 170)

NC News Roundup:
Disability Rights North Carolina releases their report regarding access to meaningful employment for people with disabilities. You can read the report at this
link.

AP News: Gary Robertson: RALEIGH, N.C. (AP) — North Carolina tax collections are on track for the state to post its highest surplus since the Great Recession.

WRAL: Crossover: Gary Robertson: RALEIGH, N.C. — North Carolina would further expand school choice programs and increase the number of people who could have criminal records erased under bills that won Senate approval Wednesday as lawmakers passed a key milestone during their two-year session.

NC Health News: Rose Hoban: Bill to get NC Homeless Kids Healthcare Passes House. Now the state Senate will consider a bill to allow homeless kids to access physical exams, dental care, mental health services and vision care.



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