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Public Policy Update – North Carolina General Assembly Update 

State Budget Adjustments Act Introduced: The NCGA is in the process this week of passing a brief budget adjustments act, HB 103. A reminder that the state passed a two-year budget for fiscal years July 2021-June 2023 last November which included additional waiver slots, increases to wages for direct support professionals, and an increase in the special education funding cap. Given the length of the last budget process and that the state is in the midst of the final stages of its Medicaid Transformation process, it seemed unlikely that additional funding or policy related to I/DD would be part of the behind-the-scenes budget negotiations during the short legislative session. The budget adjustment bill has come out as a conference report, meaning that legislators cannot amend the bill, only vote for or against.  

The budget that was unveiled on Tuesday does include some additional items that can benefit people on the autism spectrum. 

  • It allows for some more fiscal flexibilities under Medicaid to help increase access to services as the state implements Tailored Plans for people with intellectual and developmental disabilities (including autism), as well as people with serious mental health and substance use needs, in December of this year.  
  • The budget special provisions move children in the NC Health Choice health care program into regular Medicaid, giving those children more access to Medicaid state plan services including those available under Early Periodic Screening Diagnosis and Treatment regulations like Research Based Behavioral Health Treatments (RBBHT) for those on the autism spectrum.
  • DPI is directed to use federal funding to add at least 13 full time positions to provide professional development and teacher support for children 3-5 years old with disabilities in early childhood programs including preschool and kindergarten.  
  • Additional teacher raises and a new teacher bonus program can help attract and retain special education teachers and reward teachers for positive student outcomes.


Not included in the budget is either of the health care coverage gap bills that were passed during session. The Senate updated and passed HB 149, now called Expanding Access to Healthcare, and the House updated and passed SB 408, now called the Rural Health Care and Savings Act. Both propose to extend coverage to people who do not qualify for tax subsidies on the health care marketplace, though the House proposes to continue their committee work on health access issues and return in December to pass a proposal based on that committee’s work that includes gap coverage, while the Senate’s bill outlines what they want in that health care coverage and sets the process in motion soon after the bill passes. North Carlina is one of 12 states who have not yet expanded Medicaid coverage to those in the coverage gap and stands to gain an additional 2 billion in federal funding to be used for additional health services if it passes coverage gap legislation by the end of December.  

The NCGA plans to pass the budget bill by Friday and try to wrap up work on other bills by Saturday. Lawmakers will likely stay in session to address any possible veto overrides, and then return to handling interim committee meetings and any special sessions later in the year.  

The budget heads to the Governor’s desk after passage by the NCGA. Under NC law the Governor has 10 days to act on bills passed (30 days if the legislature has adjourned) and may either sign the bill into law, veto the bill, or let it become law without his signature.  


If you have questions about this or other public policy issues, please contact Jennifer Mahan, Director of Public Policy at jmahan@autismsociety-nc.org or 1-800-442-2762 x1116.



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