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The North Carolina General Assembly wrapped up its regular short session in late June after a quick seven weeks. Short sessions focus on adjustments to the budget and passing bills that were still under consideration for both chambers the previous year. This year’s state budget (SB 99 State Budget Adjustments) comes in at $23.9 billion. The health and human services budget for the intellectual and developmental disability community is a mixed bag; it included some positive special provisions but also some significant funding cuts.

Health and Human Services Budget: This budget did not include funding for more Innovation slots. Four hundred new slots came into the system on Jan. 1, 2018, but those were funded in the previous budget. Single-stream funding, which supports services for people who do not have health care or are waiting for services (inclusive of IPRS services), continues to be cut. Nonrecurring cuts were increased from $54,605,823 to $71,189,458, an additional reduction of $17 million. Recurring cuts were increased as well, from $36,002,854 to $36,440,895, an additional $438,000. Local Management Entities/Managed Care Organizations (LME/MCOs) were again directed to maintain levels of service even with cuts by using their fund balances, but we expect that we will see tighter restrictions on who qualifies for state-funded services (such as IPRS) and enforcement of existing income limits.

Budget Special Provisions: Every budget contains language that directs how funds should be used including new policies, studies, and required reports.

The ongoing problem with lack of funding to support people already living in IDD group homes was addressed with a special provision that directs the NC 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. (SB 335 Budget Technical Corrections Bill: page 12). A report on the plan is due back to the Joint Legislative Oversight Committees on Medicaid and Health and Human Services by Jan. 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. (SB 99 State Budget Adjustments: page 232)

Education Budget: Teachers will see a 6.5% salary increase, up from 6.2% in the previous budget. No additional changes were made to the local caps on special-education funds or to overall per-student funding for special education.

School Safety Committee: This past year, the NCGA House Select Committee on School Safety met in response to school shootings and issued initial recommendations for safer schools. ASNC advocated for several things with the committee: to focus on support and services in schools, not on increasing criminal penalties for students; to ensure that students identified as at-risk are able to access behavioral health services; and to ensure that students with disabilities retain their rights to education. The full set of recommendations and other findings can be read on the committee’s website.

Some of the School Safety Committee’s recommendations were funded in this year’s budget (S99: page 35) including:

• Crisis grant funding: $2 million in onetime funding
• Mental Health Support Personnel Funding: $10 million in onetime funding
• $12 million in recurring funding for grants to public elementary and middle schools for school resource officers
• $3 million in onetime 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 million in onetime funds for grants for safety equipment

 

Other bills of interest that passed during the short session

HB 403: Medicaid and Behavioral Health Modifications: This legislation clarifies previous legislation that will transform North Carolina’s Medicaid system into a managed-care model that integrates physical health care with intellectual and developmental disabilities, mental health, and substance use disorder services. The state has been operating a public managed-care system for IDD/MH/SUD services, but the new legislation permits the NC Department of Health and Human Services to move forward with the implementation of standard plans and the creation of behavioral health/IDD tailored plans that will focus on integrating physical and behavioral/developmental services. It also clarifies that all publicly operated prepaid health plans will cover some mental health services, research-based intensive behavioral health treatment for autism, diagnostic assessment services, and other Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services for those who qualify. The legislation puts forward a timeline for transformation and clarifies the role of our existing LME/MCO system. ASNC will be providing more information about managed-care changes and HB 403 in future blogs.

SB 768: People First Language 2018: This legislation represents the efforts of the NC General Assembly and self-advocates to remove the “R” word, as well as other outdated and derogatory terms for people with disabilities, from our state statutes. This effort began in 2009 with the passage of the first people-first language bill that directed legislative drafting staff on the importance of using people-first language in bill drafting. When drafting legislation and updating state laws, language should reflect the person with a disability as a person first, should 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” across numerous state laws.

 

If you have questions about policy issues, please contact Jennifer Mahan, ASNC Director of Public Policy, at jmahan@autismsociety-nc.org  or 919-865-5068.

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