American Rescue Act: Congress passed an additional COVID and economic relief bill – the American Rescue Plan (ARP) – in early March. The legislation includes a number of items meant to address ongoing problems related to the pandemic including $1,400 stimulus checks for many Americans (including dependents and individuals with disabilities); an extension of unemployment benefits; additional funding for COVID-19 vaccines, testing, and treatment; billions for state and local governments including schools; and incentives for states, like North Carolina, to extend Medicaid health care benefits to the uninsured.
Some specific items that we believe can directly benefit people with disabilities include:
Home and Community-based Services (HCBS) Funds: The ARP includes 12.67 billion in additional Medicaid funding that can be used for to ensure that people with disabilities have the option to live outside of congregate settings, where the risk of COVID is much higher. States would have the option of receiving a 10 percentage point increase in their Medicaid matching rate for HCBS services (subject to a 95 percent limit) for one year starting April 1, 2021. As a condition of the increase, states would be required to use this additional funding to expand and enhance HCBS in one or more listed ways, including reducing HCBS waiting lists; increasing HCBS reimbursement rates and providing “retainer” payments to financially stressed providers; and addressing HCBS providers’ higher COVID-19 related costs such as hazard and overtime pay, emergency supplies and equipment, training, education, and recruitment. States would be required to maintain, not supplant, their level of HCBS spending as of April 1, 2021.
Overall Public Education Funding: There is 123 billion total in new funding for school districts over the next 3.5 school years in the ARP. These funds are not special education/IDEA specific, but can be used flexibly across K-12 education to boot overall education funding, support safe reopening for schools, support mental health and behavioral issues in schools, help address disadvantaged school districts, and help children make up for lost schooling over the last year. At least 20% of the funds are required to address learning loss.
- Special Education and Early Intervention Funds: new $3 billion in funding to states for grants under the Individuals with Disabilities Education Act (IDEA) that includes:
- $2,580,000,000 for grants to States under part B of the Individuals with Disabilities Education Act;
- $200,000,000 for preschool grants under section 619 of the Individuals with Disabilities Education Act;
- $250,000,000 for programs for infants and toddlers with disabilities under part C of the Individuals with Disabilities Education Act(Child Find and early intervention funding).
Access to health care for low-income individuals: Under the Affordable Care Act (ACA), individuals earning less than 150% of the federal poverty level (FPL) will be eligible for a health insurance plan with $0 premiums. Individuals between 150-400% FPL will benefit from lower required contributions to their premiums. And for the first time, individuals over 400% FPL will be eligible for tax credits and their premium contributions would be capped at 8.5% of income. These changes last for two years.
Medicaid Expansion Incentives: The ARP also includes a two-year incentive for the 14 states, like North Carolina, that have not yet expanded Medicaid under the ACA. In addition to receiving a 90% federal match for newly covering the expansion population, states would also receive an additional 5% federal funding for all other Medicaid populations for two years. According to the Center on Budget, this increase would more than pay for an expansion, providing states financial support beyond the cost of expanding coverage. NC DHHS estimates that this could increase federal funding for Medicaid in North Carolina by a billion dollars, once the costs of expansion are factored in.
Other Federal Bills Introduced:
Disability Employment Incentive Act: On March 9, Senator Casey (D-PA), along with Senators Van Hollen (D-MD), Blumenthal (D-CT), Duckworth (D-IL), Brown (D-OH), Klobuchar (D-MN), Feinstein (D-CA), and Gillibrand (D-NY), re-introduced the Disability Employment Incentive Act (S. 630). This bill expands tax credits and deductions as an incentive that are available for employers who hire and retain employees with disabilities.
Fully Fund IDEA: Senator Chris Van Hollen (D-MD) and Representative Susie Lee (D-NV.) recently introduced the Keep Our Promise to America’s Children and Teachers (PACT) Act. This legislation (S.72 & H.R. 764) would put Congress on a ten-year path to fully fund special education services provided under the Individuals with Disabilities Education Act (IDEA) and Title I of the Elementary and Secondary Education Act (ESSA) on a mandatory basis. IDEA authorizes Congress to fund 40 percent per pupil expenditure for special education; however, Congress currently only provides about 14 percent.
North Carolina State Government
Governor Roy Cooper released his recommended two-year state budget, which calls for spending $27.4 billion in the first year, eight percent higher than his 2019 proposal, and which includes Medicaid Expansion and pay raises for teachers and other state employees.
Here are some highlights from Governor Cooper’s budget proposal which may directly affect the people with autism and their families:
- Funds for 520 waiver slots as well as 60 million to address funding to address direct care and early childhood workforce issues (workforce funds are across children, aging and disabilities)
- 30 million for increased housing and employment for people with disabilities (15 million housing trust fund, 15 million to address)
- 10 million in funds for individualized early intervention
- Funding for another 1,500 slots in the state’s pre-kindergarten program
- 305 million for resources for at risk children, including special education (removes funding caps, increases allocations)
- 5 million for reducing the implicit bias of students of color and students with disabilities in early education
- 10% raises for K-12 educators over the next two years as well as targeted bonuses for public school teachers in both years – which we hope will help to attract and retain special education teachers
- Restoration of the state Earned Income Tax Credit and a new child-care tax credit
- 5 million for transportation (Integrated Mobility – Rural Operating Assistance Program which supports transit for those with disabilities and was cut in previous budgets)
- The proposal also funds benefits counseling in VocRehab, adaptive equipment and other items not mentioned above.
As State Budget Director Charles Perusse noted in his presentation of the Governor’s budget to state lawmakers this week, this is “just the first inning” in the budget process. The NC Senate is taking the lead on passing an appropriations bill this year and Senate and House leadership have been quietly working behind closed doors on their budget proposals trying to identify areas of agreement between the two chambers and the Governor. At this point, the exact timing for the release of the Senate’s proposed two-year spending plan is not yet known, however, we do anticipate it being released in the next few weeks. Much of what ASNC has been advocating for has been heard by the Governor and state agencies in this proposal and we are very grateful for the support going into budget negotiations.
Recent NCGA and State Activity:
HB 249 Children with Disabilities Funding Formula: This bill would direct DPI to study the funding formula for children with disabilities and special education in public schools including the benefits of a model that based funding on the severity of disability type. The bill also increases the cap on the current funding formula for children with disabilities from 12.75% to 13%. The study report would be due to legislative education committees by February 15, 2022.
HB 389 and S350 North Carolina Innovations Waiver Act of 2021: These companion bills, HB 389 and S350, filed in the House and Senate would fund an additional 1000 Innovations home and community waiver slots including 200 set aside for the development of a tired waiver to address those with lower acuities using a lower spending cap. The bill additionally requires NC DHHS to convene a stakeholder group to develop a ten-year plan to address the registry of unmet needs aka those waiting for services.
Behavior Analyst Licensure Bill: Legislators in both the House and Senate are supporting legislation which would provide a path for behavior analysts to obtain licensure and practice on their own. House Bill 91 and Senate Bill 103, both titled Reduce Reg. To Help Children with Autism, have passed their respective chambers. The Senate’s version made some technical changes and is now being heard in House Committees. Should that be go to the House floor for a vote, it would then go to the Governor for a signature. The House bill (currently in the Senate) would no longer be needed. ASNC has long supported licensing behavior analysts through this and previous versions of the legislation, but we are not actively working on the legislation.
Vaccine Priority Opening Up to All: NC DHHS recently announced that they expect to open up vaccine eligibility to all North Carolinians 16 years of age and over by April 7. Access for frontline workers and congregate settings (like dorms) who were not in earlier high-risk groups will open March 31. Note: vaccines have not yet been approved for those under 16 and only the Pfizer vaccine is currently approved for those 16-18.
The NC General Assembly makes direct decisions about how many Innovations waiver slots are funded, how much funding goes to help IDD services for people without insurance, and how much is available for special education and services that support IEPs, just to name a few of our priorities. As part of our public policy advocacy ASNC’s lobbyists are meeting with budget chairs and other legislators, urging them to prioritize funding for waiver slots, direct support staff wages, other funding for services across the spectrum, and for all our policy priorities.
How you can help –
The Autism Society of North Carolina will stand up for what is needed for this community, but it’s not possible for ASNC to do this advocacy on our own. We urge you to write to your NCGA members:
- Introduce yourself and how you are connected to autism.
- Tell them your story of how having, or not having, services is affecting you.
- Ask them to fund what is needed for you, or your family, and others on the autism spectrum.
ASNC can help your frame your story. View the following resources on our website:
The NCGA website will help you identify who represents you. Check the circle for NC House and NC Senate to see who represents you in the NC General Assembly.
Please contact Jennifer Mahan, ASNC Director of Public Policy, email@example.com for assistance with these issues and other questions about advocacy.
Thank you to the Autism Society of America for providing assistance with the content related to recent Federal legislation.Tags: ASNC, autism, autism advocacy, autism insurance, autism legislation, autism medicaid, autism Medicaid Services, autism nc, legislation, managed care, medicaid, NC state budget, ncga, North Carolina General Assembly, public policy