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Weekly Policy Update: COVID-19 Policy Changes

May 5th, 2020

By Jennifer Mahan, Director of Public Policy

 This post covers April 29 – May 5.

 

COVID-19 Legislation Passes, Signed by Governor
The General Assembly has passed, and the Governor signed, the first COVID-19 bills, H1043 (Funding) and S704 (Policy) which make up the first package of relief to address COVID related issues across health care, education, state operations, and small business loan programs, local government, and other economic relief.

Health Care Funding: Most funding will address protective equipment, expand testing and contact surveillance, and shortfalls in Medicaid, rural hospitals, and federally funded clinics.

    • $20 million to the seven LME/MOCs for MHDDSAS services:
      • $12.6 million would address funding for Intermediate Care Facilities
      • 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 LME/MCOs 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.

Health Care Policy Changes – The legislation makes COVID-19 related health policy changes including adjusting healthcare liability for COVID-19 services delivered during the emergency and suspending inspections and monitoring of health care facilities, except to avoid cases of serious injury or death, or where they cannot be suspended.  Facilities that had violations for infection control in the six months prior to the COVID-19 outbreak would have mandatory training in infection control. Other changes include:

    • DHHS is required to come up with a plan for the state’s personal protective equipment stockpile including access, increasing procurement, and finding ways to increase production.
    • The state will do a pandemic healthcare workforce study including the adequacy of the workforce, training, the impact on existing workforce shortages, the impact of limiting non-essential procedures, interruptions in the delay of routine health care, telehealth, health disparities impact, and other issues including the delivery of behavioral health.

Education Funding and Policy: The bill waives testing requirements, grading requirements, delays class size reductions, and waives other requirements.

    • Funding increases would help schools prepare for more remote learning, including the purchase of computers and other devices, increase access to internet connectivity, and train school personnel on remote learning.
    • Funding is increased to school nutrition programs and to cleaning and safety measures.
    • Universities and community colleges received funding to address COVID19 related costs.
    • K-12 school calendars would be adjusted so that traditional year schools begin August 17, and should schools need to continue remote learning for the 2020-2021 school year, that could not begin until August 24th.
    • Adds language that helps to ensure students with disabilities have equal access to the remote instruction provided by their public school units and that remote instruction is provided in a manner consistent with each student’s individualized education program (IEP) or 504 plan. “Remote learning day supports shall be considered and included, as appropriate for the student, when an IEP or 504 plan is initially developed or at any subsequent review or revision of an IEP or 504 plan” according to the bill which would be implemented in August for the 2020-2021 school year.
    • $70 million in summer learning programs in reading and math for struggling K-4th grade students, to help address the suspension of requirements for third-grade proficiency.
    • $10 million increase for K-12 schools to address health and mental health of students.

 

Access to Services and Medicaid Changes
North Carolina has approved additional telehealth access for B3, Innovations, and TBI waiver services.  

  • SPECIAL BULLETIN COVID-19 #75: This bulletin modifies Innovations and TBI Waivers Appendix K and Developmental Disability State-Funded Benefit Plans.
  • SPECIAL BULLETIN COVID-19 #76: This bulletin provides for Behavioral Health Service Flexibilities through (b)(3) Services.
  • SPECIAL BULLETIN COVID-19 #70: This bulletin allows delivery fees for retail stores to deliver prescriptions that can be included in Medicaid and Health Choice payments.  

 

NCGA Short Session to Begin This Month
Lawmakers are now planning to return to Raleigh for a regular “short session” on May 18th. At this time, they have said they are planning to consider other COVID-19 related legislation not considered in the first bill, take up additional budgetary changes needed, and any remaining policy changes.

COVID-19 Committee meetings will continue during the two-week interim between sessions. Legislative leaders are considering how meetings and sessions will be conducted following any pending changes to the state’s stay at home orders, including who/how many will be allowed inside legislative buildings. For now, the public can listen or view committee meetings online at www.ncleg.net by checking the calendar or following Senate Committee 136 and House Select Committee 199. 

 

How You Can Help!
As mentioned, the NCGA COVID–19 committees are all looking at additional bills for lawmakers’ expected return to Raleigh May 18. Funding in the first COVID–19 emergency legislation did little to address services and supports for those on the waiting list, the 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. 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 currently open to the public. Find contact information for your representatives here. 

  • 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 all 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 COVID–19 status. 
  • Allocate funding to support Medicaid Transformation so the needs of the whole person can be addressed, and care management can be restored.  

 

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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