This article was published in The Autism Society of North Carolina’s summer 2011 issue of The Spectrum. Current and past issues of The Spectrum can be found under Publications on our website.
Families, self-advocates and ASNC faced difficult challenges in advocating for better services and supports for people on the autism spectrum as we headed into the long North Carolina General Assembly legislative session in January: ongoing tough economic times with a 2.2 billion dollar state budget deficit, new legislators unfamiliar with our needs, pressure from interest groups opposed to policy changes, and a determination across state government to use managed care for services to those with developmental disabilities. ASNC pushed policymakers to think about the effects their decisions would have today and in the future. While we did not achieve all we set out to do, we were able to have some significant impacts.
Budget: At the beginning of the year, policymakers were expecting to make large cuts to all programs, including those that serve developmental disabilities. By the end, suggested cuts had been significantly reduced. Most cuts to Medicaid we hope will come from efficiencies, connecting people to primary care services and better management tools. Cuts to state service funds were reduced to a $20 million onetime cut from a recurring $30 million cut. Cuts to non-profit programs went from $ 10 million down to $ 5 million. Still, there will be significant impact; service providers have taken rate cuts for the last three years, despite needing to meet increasing quality standards and rising costs. Any reductions in a system that already struggles with waiting lists will likely come at the cost of people losing access to needed services and supports.
Other programs impacting children took deep cuts: Schools were cut by 408 million; early childhood education and development were cut by more than $55 million. Additionally, evidence backed programs like Smart Start will no longer be able to promote health screenings that help with early identification of children at risk for development problems. ASNC pushed for legislators to take a balanced approach and keep current revenue streams in place to support these needed programs. Despite public support, legislators allowed the penny sales tax to sunset on June 30th.
Managed Care Waivers: ASNC has made it a priority to advocate for I/DD system management options other than 1915 b/c managed care waivers for people with Autism Spectrum Disorder. Of greatest concern under managed care is the elimination of independent case management which creates a conflict of interest in managing the use of services (i.e. the cost of care) and determining an individual’s needs and plan of care. As the session progressed, it became clear that policymakers were determined to push managed care across the entire system. ASNC pushed for additional consumer protections and for the voice of families, self advocates and local communities to be heard in the process. Please see page 16 for expanded information about the new managed care waivers in North Carolina.
Autism Insurance Coverage: Autism insurance bill sponsors introduced very good bills this year, Senate Bill 115 and House Bill 826, Coverage for Treatment of Autism Disorders. This bill ensure that North Carolina health plans cover services for ASD, so it’s disappointing that autism insurance legislation has not moved forward in the NC General Assembly this session. We all know it’s the right thing to do, so that those with autism get the services they need to be healthy and successful. We also know that it will save money in the long run by promoting independence.
Unfortunately, to get it passed, we need to convince NC General Assembly lawmakers to raise insurance standards in both private and public health plans, which is estimated to increase costs less than 1%. At this time, many lawmakers are against taking actions which would result in higher costs to business or state health plans. This is not the only reason that autism insurance bills have not passed, but it is a huge factor. Other factors include a lack of understanding about Autism Spectrum Disorder and its treatments, as well as opposition from powerful interests like the insurance industry and business associations.
The bill is still alive and will carry over to the short Legislative session in May-June of 2012. Between now and then, families, self-advocates, autism professionals, and other advocacy organizations must meet with their NC state General Assembly Legislators, especially those on the House Health and Human Services Committee, the House Insurance Committee, and the Senate Insurance Committee, to urge those lawmakers to pass the bill.
Tax Credits and Corporal Punishment: Autism advocates had two solid victories this past session: House Bill 344, Tax Credits for Children with Disabilities, and Senate Bill 498, Modify Law Re: Corporal Punishment. House Bill 344 Tax Credits for Children with Disabilities gives a $6,000 tax credit to families whose child with a disability moves from a public school to attend a private school or home school. To qualify for the credit, children must have been in a public school the previous two semesters, have an IEP, and be receiving special education or related services on a daily basis. The legislation also establishes a special needs trust fund to be administered by the NC Department of Education to supplement funding for special education services in the public schools. Part of the savings generated by the use of the tax credit will go to the trust.
Senate Bill 498, Modify Law Re: Corporal Punishment, requires schools to send a form at the beginning of the school year allowing parents to opt-out of corporal punishment for their children. Many families are surprised to learn that 39 counties in North Carolina still allow physical punishment and that 17 are actively using it (Numbers are correct as of this printing. Counties are moving to ban the practice and this number may drop as we get closer to the school year start.) ASNC continues to promote positive behavioral supports and an end of the use of physical punishment for all children in schools. Previously, corporal punishment had been banned for students with disabilities; however, we know from parents that students with as yet unidentified disabilities continue to be subject to corporal punishment.
Your Advocacy: One of the best outcomes of this legislative session is that we heard that Legislators heard from you. On managed care, on the budget, on education, on insurance – they got your calls, letters and emails. Having real life examples of how Autism Spectrum Disorder is impacting you and your family does make a difference in public policy. ASNC needs that advocacy to continue to build so that every Legislator hears from families, self-advocates, and others in their districts.
Victories on autism insurance, funding for services, ending waiting lists, and creating lifetime supports will be won with your action. Policymakers were moved by your stories about struggling to find the right education options to ensure your child’s success. That same action is needed in the coming year to pass better insurance standards. ASNC challenges you not only to get involved, but to ask others who know you to join in this effort. Sign up for our e-updates, write letters, and pass them along to your neighbors with the request that they do the same.
Please contact Jennifer Mahan, Director of Government Relations, with questions or concerns. She can be reached at 919-865-5068, 1-800-442-2762, ext. 1116 or jmahan@autismsociety-nc.org. You can also leave your questions or comments in the comment section below.
Tags: autism education, autism insurance, autism legislation, budget, corporal punishment, Developmental disability, education tax credits, legislation, managed care, North Carolina General Assembly, public policy