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Weekly Policy Update: COVID-19 Policy Changes

April 29th, 2020

By Jennifer Mahan, Director of Public Policy

Below is this week’s Autism Society of North Carolina (ASNC) weekly update on policy changes and legislation related to local, state, and federal COVID-19 emergency orders.

We Need Your Help! 
The North Carolina General Assembly, our state’s legislature, is back in session and focused on COVID-19 related needs. Funding in the draft bills for COVID related needs does little to address services and supports for those on the waiting list, rate changes needed to retain direct support professionals in community-based services or to support organizations who are providing services. 

The Autism Society of North Carolina continues to advocate with state agencies, LME MCOs, and the NC General Assembly for our public policy priorities, as well as the well-being, safety, and rights of people with autism during this pandemic. Because personal stories from constituents can make a significant impact we urge you to join us by contacting your elected officials. 

When you contact your North Carolina General Assembly (NCGA) House and Senate members, ask them to support people with autism and their families.  Please share your stories of life with autism. Use email and social media to reach out to your elected officials, as the legislative building is not open to the public. Find contact information for your representatives here. Let them know:

  • Funding is needed to ensure community IDD providers have the capacity to serve people, especially those in crisis. Current relief legislation such as the Payroll Protection Plan (PPP) does not offer help to provider agencies.  
  • Rate increases are needed to retain enough direct support professionals during and after the crisis.
  • There are still over 14,000 people on the waiting list for Medicaid waiver services. These individuals DO NEED supports during and immediately following the crisis – they cannot be forgotten.
  • School systems must have the funding to support students with special needs, both with remote learning and for compensatory education as they return to schools.  
  • The uninsured in North Carolina need coverage more than ever. Fill the health care coverage gap, regardless of COVID19 status.
  • Allocate funding to support Medicaid Transformation so the needs of the whole person can be addressed, and care management can be restored.  

 

An Abbreviated Legislative Session  

This year’s session began Tuesday, April 28. The NCGA is expected to hold a very short two-week legislative session to handle budgetary and policy changes needed to address the COVID19 pandemic’s effect on North Carolina. The legislative process has been adjusted to allow for members to debate, present amendments, and vote in smaller groups or vote by proxy through minority and majority party leaders. Committee meetings are taking place virtually with members participating from their own offices or homes. The public is not allowed inside the legislative building, but you can listen or view the process online at www.ncleg.net.   

  • Appropriations Committees will meet Wednesday, April 29th to finalize bills allocating funding from state and federal sources.  
  • Draft legislation from the House COVID19 Committees is expected to be voted on as soon as Thursday, April 30th, and passed on to the Senate who will consider potential changes to address their own priorities.  
  • Any differences would need to be negotiated between the two chambers before being sent to the Governor.  

At this writing, it is unclear if other legislation will be considered during this two-week period, or if legislators will return for a talked about, but not yet scheduled, a longer session in late summer. A late summer session would allow elected officials to handle budget issues once the state revenue picture is clearer.  

 

House COVID–19 Committee Recommendations  

The NCGA House Select Committee on COVID–19 has four workgroups focused on Health, Education, Economic Supports, and State Operations. Each work group’s draft bills (and updates) can be viewed here.

Workgroup draft legislation of specific interest to those on the autism spectrum and their families are: 

  • Health Care Policy – The committee has proposed numerous changes including authorizing many health care professionals to administer COVID–19 antibody tests when they become available, allowing dentists to test patients before treating them, adjusting healthcare liability for COVID–19 services delivered during the emergency, and not allowing health plans to require prior authorization for telehealth and virtual care services.   
  • Health Care Funding and Policy Recommendations – 
    • $25 million to the seven LMEs for MHDDSAS services: $12.6 million would address funding for Intermediate Care Facilities and the remainder to be used in part to address the needs of those with behavioral issues and help keep them out of emergency rooms.  
    • Increases the rates paid to fee-for-service Medicaid providers by 5%. This change does not increase rates to MHDDSAS providers paid for services that are part of LMEMCOs Medicaid managed care funds, including Innovations waiver or other behavioral care services.   
    • $40 million for Medicaid (which will draw down an additional $120 million or more in federal funding) to address COVID–19 related shortfalls and additional services needed to extend COVID related treatment to low-income people who might not otherwise qualify for Medicaid (typically lower-income adults without children).
  • Education Policy – The bill waives testing requirements, grading requirements, allows for modifications to required school calendars, allows budget flexibilities, delays class size reductions, and waives other requirements. 
  • Education Funding – Education agencies in the state (DPI, Universities, and Community Colleges) have requested additions to education funding for the coming year to address COVID–19 related issues. The committee has not yet published a set of funding recommendations for Education. 

 

 Access to Services and Medicaid Changes 

  • Medicaid and Health Choice suspend copayments related to COVID–19: NCDHHS is directing providers to stop collecting copayments from Medicaid and NC Health Choice beneficiaries on all COVID-19 related testing, services, and treatments. This change is effective retroactive to Jan.
  • Telephonic outpatient psychotherapy available under Medicaid and Health Choice: Effective April 20, 2020, NC Medicaid is temporarily modifying its Behavioral Health and Intellectual and Developmental Disability Clinical Coverage Policy 8C: Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers to better enable the delivery of care to NC Medicaid, NC Health Choice, and State-funded individuals in response to the COVID-19 Pandemic. This guidance on allowing telephonic outpatient psychotherapy is in addition to the telehealth flexibilities previously added. 

 

Governor releases COVID–19 budget 

The Governor released his $1.4-billion-dollar spending proposal for addressing COVID–19 related needs through the end of the fiscal year; prioritizing the spending of federal relief funds before state dollars.  

  • The proposal has similarities to the bills proposed by House COVID committees.  
  • The proposal has no specific funding for MHDDSA services, but an increase in public health and safety funding by $313 million for COVID related care in Medicaid and public health.  
  • There is an additional $243 million for school services, including summer and/or compensatory programming for exceptional children and those at risk for falling behind in the coming year, and $75 million for school nutrition to support students in need.  
  • Most additional funds in the Governor’s budget go to address transportation projects delayed by the loss of state highway trust funding, loans for small businesses, and funds for local governments to respond to COVID–19.  

 

Stay at home extended 

The Governor’s stay at home order has been extended to May 8th and the Administration released its 3-phase plan for reopening. The plan requires:  

  1. Reopening decisions to be driven by data showing that the state’s COVID19 symptoms, cases, confirmed tests, and hospital admissions are leveling or decreasing over a period of 14 days
  2. The state build capacity to test and do contact tracing to prevent and/or respond to  the spread of COVID–19 
  3. The state has a minimum of 30 days of personal protective equipment supplies to address demand. 

A gradual reopening would follow these benchmarks.  

 

Education Update:  

School closings and remote learning have been extended for the remainder of the school year. The governor’s statement can be read here,  and the state school board’s statement here.  

ASNC is monitoring legislative changes that include waivers of current policies for testing, grading, and school calendars, as well as funding flexibilities, some of which may impact the start dates for schools, and add additional weeks of instruction for students who may be behind or need additional educational supports/remediation. 

 

Other News 

  • COVID in congregate settings info made public: 
    Names of congregate settings such as nursing homes, correctional institutions, and other residential care settings (like group homes, family care homes, ICFs, and multi-unit assisted housing) with COVID–19 outbreaks will now be made available to the public. This information can be found on the NC COVID–19 Dashboard. 
  • NCDHHS and health professionals urge the public to make use of telehealth services during this time:
    By using telehealth, North Carolinians can receive services while avoiding the risk of exposure to COVID-19. Doctors and other clinicians across the state are using telehealth to deliver primary care and prenatal care; help patients manage asthma, diabetes, high blood pressure, and other chronic conditions; and provide behavioral health counseling, physical therapy, and more.  All insurance companies in the state, including Medicaid and Medicare, are covering healthcare visits through telehealth. DHHS and NC Medicaid have developed a video and a flyer to help alleviate concerns and encourage people to talk with their doctors about using telehealth to get the care they need to stay healthy. 

  

For daily updates, information, and help during the emergency, we recommend the following sources: 

 

If you have questions about this update or about other public policy issues, please contact ASNC’s Director of Public Policy, Jennifer Mahan at jmahan@autismsociety-nc.org.  

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