May 14 begins the “short” session of the North Carolina General Assembly. The short session takes place in even years and lasts about 6-7 weeks. Typically, legislators will make adjustments to the budget and take up a few pieces of legislation that either were not completed the previous year or are being introduced based on recommendations of study committees that met over the winter and spring. Things move quickly during the short legislative session. Be sure to sign up for our new Policy Pulse newsletter for public policy action alerts and updates.
Here are some of the main issues affecting people on the autism spectrum that might be addressed in the NC General Assembly this session:
Autism insurance reform
Why ASNC works on the issue: Health insurers unfairly discriminate against people with autism by not covering treatments as they do for other health conditions. Reforming North Carolina insurance laws would ensure that health insurance covered by state law would provide coverage of effective treatments for autism and related problems.
Status: House Bill 498 passed the NC House last session but still must be heard and voted on in the NC Senate. Write or call your senator and ask for his or her support. Urge your senator to request that Senate leadership schedule a committee hearing on H 498. (Find your state legislators and their contact information here.) ASNC will be actively working to pass the legislation this session. Watch our Facebook page, blog, Twitter feed, and Policy Pulse updates for current news.
State budget
Why ASNC works on the issue: Many autism services and supports are funded with state funds or a blend of federal and state funds. Housing, residential services, special education, respite, early intervention, vocational services, and all Medicaid services, including Innovations/CAP, require state funding. More and more people in the state are diagnosed, and those who have been diagnosed are growing up, and growing older.
Status: North Carolina created its two-year budget last year, and the first year will end June 30. The state administration is reporting a $445 million shortfall for the current fiscal year, but believes it has funds in reserve to make up the difference. The question is how much will the budget for the next fiscal year – July 1, 2014, to June 30, 2015 – be affected? Will the legislature have to make adjustments to the budget during the short session that threaten services and health care for people with disabilities? What about the ongoing problem of 10,000 people with developmental disabilities, including autism, on a waitlist for services? ASNC will be closely monitoring the budget process and working with the legislature on solutions.
Medicaid reform
Why ASNC works on the issue: Many services for people with autism are funded through the our state’s Medicaid program, which uses a combination of state and federal funds to pay for in-home and community-based care, health care, day programs, respite, employment supports, residential supports, and other services for people with disabilities. Medicaid services for people with intellectual and developmental disabilities such as Autism Spectrum Disorder are optional for states. This means that North Carolina can choose which services to provide and who may receive them; the state is not required to provide services to anyone. 10,000 people are waiting for services, and many go into crisis before they ever receive access to them.
Status: The governor’s office would like the state to move toward an integrated physical and behavioral health system for Medicaid that is more carefully managed. States that have formed Accountable Care Organizations and that are using managed care models have in some cases been able to get better health outcomes and contain rising health-care costs. Few states have integrated, well-developed, managed-care systems for people with developmental disabilities and autism. The legislature is not completely in agreement on the form Medicaid reform should take. ASNC does not have a position on the current proposals for Medicaid reform; however, during the last round of managed-care changes, ASNC stated that any change to managed care should ensure transparency (showing how decisions are made), retain case management, and focus on good outcomes for individuals including expanded coverage for the wait list, rather than just cutting costs. ASNC will be working to ensure reform efforts are consistent with these principles.
Schools and Education
Why ASNC works on the issue: Students with autism have unique education requirements. In some districts, the number of students with autism has doubled in the past decade. ASNC has supported efforts to expand school choices, but most students will still attend public schools. Budget and policy changes in education are critical to ensure reasonable class sizes, the availability of highly qualified special education teachers, and access to in-school supportive services. Bullying and policies to use positive behavioral supports are still problems. Students with disabilities have a 60% high school graduation rate, lower than their typical peers at 80%. Most lack viable transition plans that will set them up for success in adulthood.
Status: State budget holes are making it seem less likely that we will see an increase in the education budget this year, despite the need to invest in the education of students with disabilities. ASNC will be working to push for a study of transition issues and vocational options for students and youth with disabilities. Grade testing, student performance testing, and student retention are likely to come up this year, and ASNC will be monitoring any proposed education changes.
If you have questions about public policy issues, please contact Jennifer Mahan, Director of Advocacy and Public Policy, at 919-865-5068 or jmahan@autismsociety-nc.org.
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