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Below is a summary and review of recent activity at the state and federal level. This includes COVID-19 related information and other legislative issues.

Washington Update – No movement

The US Senate has yet to respond to the passing of the HEROES Act. Our state is facing large budget deficits as a result of COVID-19’s impact on the economy and tax revenue. We urge you to contact Senator Burr and Senator Tillis to ask that the next stimulus and economic support bill passed by Congress address the needs of people with autism and their families in North Carolina by:

• Including funding for home and community-based services, the largest program supporting people with I/DD, to help people with disabilities and enable them to remain in their communities
• Supporting direct care professionals as an essential part of our health and disability infrastructure: designate them as “essential workers” under any legislation that supports increased wages such as outlined in the “Heroes Fund”
• Increasing funding for the housing programs that help people with disabilities obtain accessible, affordable, integrated housing, and avoid unnecessary placement in congregate settings, including the Section 8 Housing Choice Voucher program and the Section 811 Supportive Housing for Persons with Disabilities program, as well as protection against evictions and foreclosures throughout the crisis
• Allocating additional funding for the Public Health & Social Services Emergency Fund. To date, Congress has appropriated $175 billion to this fund, but the U.S. Department of Health & Human Services has failed to allocate any of this relief to community disability providers
• Ensuring access to personal protective equipment (PPE) for direct care workers, who are on the front lines of this crisis
• Providing recovery rebates to all people with disabilities, including adults who may be claimed as dependents, without jeopardizing access to benefits programs.

 

 

 

Raleigh Update – North Carolina General Assembly (NCGA) finishes short session –

The NCGA wrapped up their work for the short session by passing a series of mini-budget bills for Health and Human Services, Medicaid, Education and other areas of state government, that included policy changes and the use of additional funds from COVID-19 relief previously allocated by the federal government. Our state is facing a $4-6 billion shortfall in the budget due to the impact of COVID-19 on economic activity, including retail sales, unemployment, reduced driving/gas purchases, etc. In the absence of an accurate revenue picture, the NCGA based its budget projections on the ‘16-17 budget year to meet the legislature’s constitutional requirement for a balanced budget.

The Legislature will hold skeletal sessions through Saturday, July 11 in the event Governor Cooper vetoes a bill that may need override consideration. At that point, the General Assembly will officially adjourn to reconvene on Wednesday, September 2 to review revenue numbers, address any additional budget adjustments, shortfalls, and possibly allocate other federal funding for state budget relief. That session would allow them to consider other legislation still active for this current session.

The following is a summary of the legislation ASNC was monitoring or advocating on during the short session. Bills that did not pass may still be under consideration for later in the year. Bills that passed the NCGA may still be pending the Governor’s signature, veto, or lacking either, passage into law following 30 days of inaction.

Rights and Safety, including Voting/Elections:

• DID NOT PASS, S730, the No Patient Left Alone Act – The bill would have ensured visitation rights for hospital patients during a disaster declaration or public health emergency. The bill changed as it moved through the legislative process and the language requiring accommodations in hospitals was watered down somewhat to state they would be accommodated “unless the individual’s presence infringes on others’ rights or safety or is medically or therapeutically contraindicated.” Amendments to the bill created 1) a $10 million testing and tracing program as part of a business reopening initiative and 2) a $100 million business relief fund for small to medium-sized businesses in the state that did not qualify for other relief funds. The Senate voted not to concur with these changes and unless a new conference committee is appointed to sort out differences in the House and Senate versions, the bill is considered dead.
• DID NOT PASS, H1173, Disallowing Rules – This bill would have disallowed updates to rules for health and safety in the operation of jails and remains in committee. ASNC and its partner organizations signed on to letters opposing H1173 and advocated for the new jail rules to be allowed to move forward as planned. ASNC and other disability organizations recognize the rights of individuals with IDD to have access to appropriate screening, health care, well-being, and safety measures when incarcerated. The rules were developed in conjunction with stakeholders, state agencies, and experts and reflect our current understanding of how to keep people safe and well inside jails.
  • Related to the above disallowing rules bill, ASNC has been monitoring H612 DHHS Review of Procedures/Criminal History/OAH (PASSED, but status pending Governor action) due to amendments that included provisions to alter rule-making authority for Medicaid and Health Choice. H612 as passed does not include this provision and is back to its original intent to review the Department of Social Services rules and regulations, clarify the authority of licensing boards to require criminal history checks, and update the process for legislative review of rules. Please note: OAH Rulemaking allows for public notification and input into the regulations for how the state will implement various programs. By state law, Legislators are allowed to introduce legislation that would disallow rules established by state rulemaking authorities.
• PASSED, H1169, The Bipartisan Elections Act of 2020 – H1169 was signed into law on June 12, and addresses changes needed to limit the spread of COVID-19 as crowds gather to vote.The new law will make it easier to vote via absentee ballot by requiring only one witness signature and allowing for multiple ways to request absentee/mail-in ballots. The bill also included amendments added to it to allow for the use of additional government-issued photo identification in voting; bill sponsors have said they are trying to address legal issues that have halted the requiring photo ID for voting in North Carolina. Voter ID will not be required for the upcoming November elections but may be required in the future.
• DID NOT PASS, S828 would also would also make it easier to submit absentee ballots in NC by removing the requirements for witnesses or a notary, with the passage of H1169, we do not expect S 828 to move forward.

 

ASNC continues to monitor changes to elections laws to ensure voters can vote including obtaining ID, if and when needed, and the implementation of any other changes to voting laws.

 

Schools and Education:

• PASSED, S476 – This bill requires schools to address suicide prevention, though without added funding and was signed into law on June 8. DPI will adopt a model mental health training program and suicide risk protocol for schools and schools are to adopt a school-based mental health plan to address training, referrals, and students at risk for suicide.
• PASSED, S818 – Compensation of School Employees – funds $350 teacher bonuses, but keeps salaries at current levels with steps raises for experience.
• DID NOT PASS, H1181 and H1182 – Bills to appropriate additional COVID relief funds for education. H1181 included $25 million in grants for schools to address the needs of exceptions children during COVID-19.
• DID NOT PASS, H1206/S844, Student Mental Well-Being – would increase school counselors, social workers, and school psychologists serving schools.
• DID NOT PASS, H1203/S850 Ensure Healthy Schools/COVID – this legislation would add school nurses to every school.
• DID NOT PASS, H1228 and S859 would have expanded access to internet broadband for remote learning for students in K-12 schools, community colleges, and universities;
  • Related, DID NOT PASS, H 1105 COVID/ Supplementary G.R.E.A.T. Grant Period (aka rural broadband expansion) –  would have added $30 million in COVID relief funding to supplement a grants program for broadband infrastructure. [While LEAs are addressing wifi and remote learning with the initial round of COVID relief funds with things like “smart buses” and hot spots, broadband access in rural areas is a longstanding problem.]

 

Medicaid, Health Care, and Human Services:

• PASSED (pending Governor action), S168 DHHS &Revisions –  contains a large number of changes to state law including a developmental disability definition correction to align NC with the federal definition, state-funded services co-payment clarifying language, and authorization for federal block grant funding. The bill also included an amendment added during the conference committee process that public records experts believe would limit public information on death records. For that reason, the bill may not be signed by the Governor, or if it is, this public records issue may be revisited by the NCGA in an upcoming session.
• DID NOT PASS ,H488 Address Direct Support Professional Staffing Crisis – This bill would address rates paid to Intermiediate Care Facilities to address the lack of a comparable increase to rates paid for similar state facilities and help address the shortage of direct support professionals in facility-based IDD services. The bill also contains a study for similar Direct Support Professional shortages and rate issues in community-based Innovations waiver services.
• PASSED, (pending Governor action), S808 – funds Medicaid Transformation which has been on hold since the budget impasse last year; funds the Medicaid rebase; adds $50 million to support the expected budget hole/increase in service needs for LME MCO services and gives DHHS oversight for use of “savings” generated by the LME MCOs; directs funding to move DHHS offices from the Dix Campus to an as yet to be determined site in Wake County, removing the requirement that they move to Granville.
• DID NOT PASS, S834 – comes up with a more scaled-back approach than H1040 to fill the health insurance coverage gap in North Carolina by only covering single adults up to 133% of poverty, instead of all those in the gap, but does so without the work requirements in H1040; and
• DID NOT PASS, H1196 – which would fund additional testing and protective equipment for congregate living facilities.

 

Note that none of the mini-budget bills passed during the short session contained funding to support services for 14,000+ people on waiting lists, nor an overall rate increase for Medicaid waiver services. (1,000 waiver slots were in a 2019-2021 budget that was vetoed and never enacted.)

 

General Budget (new)

• PASSED, (pending Governor action), H1023 Coronavirus Relief Funds/Additions & Revisions
  • Subdivision (53) allocates $2.6M for the NC HealthConnex health information exchange network for certain COVID-19 related improvements and operations.
  • Subdivision (64) allocates $5M to DPI for grants to applicant public school units for services for exceptional children who lost critical services due to COVID-19 related school closures.
  • Subdivision (67) allocates $5M to DHHS, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, for 122C group homes that serve minors or adults with intellectual and/or developmental disabilities, to support the implementation of Centers for Disease Control and Prevention guidance for preventive measures to control the spread of COVID-19 in these facilities.
• DID NOT PASS, S805, which would take $645.4 million from remaining federal CARES Act money “to offset General Fund appropriations across state government for expenditures allowable under The CARES Act.” With an expected budget shortfall of 4-6 billion, budget writers are trying to use as much of the funding from the federal CARES Act to support programs and services as possible. House and Senate versions have passed each chamber, but no conference committee has been named to iron out differences. It’s likely the bill is on hold until the NCGA returns later in the year to consider budget shortfalls and the use of federal relief funds. 

 

Governor’s Executive Orders

NC Governor Roy Cooper issued Executive Order 147 on June 24. Cases of COVID-19 and hospitalizations for complications due to COVID are unfortunately on the rise in the state so additional precautions are required.The order:

• Extends Phase 2 Safer at Home restrictions until July 17 (unless extended further)
• Requires people to wear face coverings (face masks or similar) in public when social distancing is not possible.  Read FAQs on the order here.
  • Masks are required in public places like retail, restaurants, personal care places, workplaces, child care centers, public transportation (including private ride-sharing services), and long term care facilities.
  • There are some exceptions to mask-wearing and we suggest you read the order and/or the FAQ for details on the requirements and the exceptions. While everyone is expected to follow the order to reduce transmission of the virus, some adults or children with autism may be unable to wear a mask. This situation should be covered under the following exceptions:
    • “Should not wear a face-covering due to any medical or behavioral condition or disability (including, but not limited to, any person who has trouble breathing, or is unconscious or incapacitated, or is otherwise unable to put on or remove the face covering without assistance);”
    • “Is a child whose parent, guardian, or responsible person has been unable to place the face-covering safely on the child’s face.”

The ASNC COVID-19 page has a social narrative for mask-wearing that may be helpful for some individuals, as well as other COVID-19 related resources.

 

NC DHHS Updates

Community transmission of COVID-19 has increased, including among historically marginalized communities and in the Latinx populations. NC DHHS has updated its testing guidelines and is encouraging increased testing, even for those without symptoms, expanded contact tracing, and adherence to quarantine and social isolation measures.

The guidance recommends that clinicians conduct or arrange for diagnostic COVID-19 testing for:

• Anyone with symptoms suggestive of COVID-19.
• Close contacts of known positive cases, regardless of symptoms.
• The following groups are some of the populations with a higher risk of exposure or a higher risk of severe disease if they become infected. People in these groups should get tested if they believe they may have been exposed to COVID-19, whether or not they have symptoms.
  • People who live in or have regular contact with high-risk settings (e.g., long-term care facility, homeless shelter, correctional facility, migrant farmworker camp).
  • Historically marginalized populations who may be at higher risk for exposure.
  • Frontline and essential workers (grocery store clerks, gas station attendants, child care workers, construction sites, processing plants, etc.) in settings where social distancing is difficult to maintain.
  • Health care workers or first responders (e.g. EMS, law enforcement, fire department, military).
  • People who are at high risk of severe illness (e.g., people over 65 years of age, people of any age with underlying health conditions).
  • People who have attended protests, rallies, or other mass gatherings could have been exposed to someone with COVID-19 or could have exposed others. Testing should be considered for people who attended such events, particularly if they were in crowds or other situations where they couldn’t practice effective social distancing.

 

To that end, NCDHHS has also put in place new tools to help people know if they should consider being tested for COVID-19 and to find a nearby testing place.

• Check My Symptoms, a public website that allows people to enter their symptoms to determine if they should consider getting tested for COVID-19. If a test is recommended, they will receive a link to a list of nearby testing sites via email or text.
• Find My Testing Place, a public website that allows people to enter their county or ZIP code and access a list of nearby testing site locations online.
• The COVID-19 Community Team made up of trained local Health Department staff and Community team members who are serving as contact tracers across the state.
  • Team members reach out to people who have tested positive for COVID-19, or anyone who has been near someone with COVID-19 and get them the information and support they need. This support can include helping someone understand what it means to have been exposed to COVID-19, how to monitor their symptoms when to get tested, if needed, and how to protect their loved ones.
  • When the COVID-19 Community Team reaches out, it is important for people to answer the call. Individuals being contacted would get an initial text from the number 45394 or email from NC-ARIAS-NoReply@dhhs.nc.gov with follow-up phone calls from NC OUTREACH (844-628-7223) or the Local Health Department. The Community Team represents North Carolinians across the state and will be available to provide support and information in multiple languages.

 

Please share your stories of life with autism with your state and federal officials, especially as they relate to access to services, supports, and health care; access to education; health and disability services system in NC; and your rights.  Find contact information for your representatives here so you can connect.

Questions? Please contact Jennifer Mahan, Director of Public Policy at jmahan@autismsociety-nc.org.

 

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