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Weekly Policy Update: COVID-19 Policy Changes

The Autism Society of North Carolina will issue weekly updates, including calls to action, on policy changes and legislation related to COVID-19, local, state, and federal emergency orders. For daily updates and information, we recommend the following sources: 


Our public policy advocacy continues and is as important as ever
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The Autism Society of North Carolina (ASNC) is working with Administration, our Governor, DHHS, Emergency Management, and LME/MCOs to ensure needed services and supports continue where possible, and/or be delivered in alternative ways. While schools are closed, we are advocating with the NC Department of Public Instruction (DPI) and school systems to support the rights to education as districts figure out how to deliver education in new ways. Finally, we are monitoring and advocating on issues that were not or have not yet been addressed by recent Congressional legislation or State of NC Executive orders. These include things like access to additional services and supports, rate increases, stabilization of direct care workforce, and stabilization of intellectual and/or developmental disabilities (I/DD) provider organizations. 


What you can do to help
: 
We encourage you to share your stories of life with autism with your state and federal officials, especially as they relate to access to: services, supports, and health care; access to education; health and disability services system in NC; and your rights. Get tips on advocating on our website. 

You have two US senators in Congress: Sen. Richard Burr and Sen. Thom Tillis; you have one of 13 members of Congress in the US House representing your district. You have two elected officials to the NC General Assembly (House and Senate) based on the districts you live in. Find contact information for your representatives here: www.ncleg.gov/FindYourLegislators so you can connect. 


Congress has already passed 
three bills intended to help during this national emergency. (More info below on the latest legislation). Additional bills are in the works. 

You can help by contacting your members of Congress via email, Facebook, and Twitter and letting them know that additional stimulus bills and bills to support people during this emergency must address the needs of people with autism and their families: 

  • Grants to support home and community-based services and education for students with disabilities 
  • Paid leave coverage for all caregivers and people with disabilities 
  • Ongoing emergency income relief that includes people with disabilities, families, and caregivers and does not jeopardize their access to safety net programs such as Social Security, Medicaid, SNAP, etc. 


The North Carolina General Assembly is out of session. They have formed a 
bipartisan committee to work with crisis response groups to begin addressing COVID-19-related policy issues. Additional COVID-19 related committees began meeting remotely March 25th. You can see the legislative calendar on the NCGA website at www.ncleg.gov.  

You can contact your members of the NC General Assembly, our state’s legislature, to urge them to support people with disabilities and their families during this time 

  • Address the lengthy waiting list for I/DD services and supports and the rate increases needed to retain enough direct support professionals
  • Ensure community providers have the capacity to serve additional people, especially those in crisis
  • Address resources for school systems to support students with special needs  
  • Fill the health care coverage gap  
  • Allocate funding to support Medicaid Transformation 

 

Recent Events: 

The Governor issued a stay at home order to help curb the spread of COVID 19 infection:
The stay at home order is intended to delay infections so that hospitals and other health care systems are not overwhelmed by the number of serious cases and can take care of those that get too sick to remain at home. Everyone is urged to stay at home and limit social interactions and travel only for essential purposes. To learn more about the order and what is included read this FAQ. 

Group Home/Long-Term Care Facility visits are also now restricted:
For safety reasons, the Governor’s executive order halts visits to long-term care facilities including *all* group homes, adult care homes, family care homes, skilled nursing facilities, and intermediate care facilities for I/DD. Although the order only mentions one type of group home, guidance from NC DHHS states that it extends to all group homes, including I/DD. 

Food assistance expanded:
Parents who need food assistance for their children can text FOODNC to 877-877 to locate nearby free meal sites. The texting service is also available in Spanish by texting COMIDA to 877-877.  Additionally, No Kid Hungry NC has created a map of local school sites, community organizations and food assistance programs across North Carolina where families can access food. The interactive map can be viewed at nokidhungrync.org/covid19/ and is updated daily. 

 

Stimulus bills passed:
Congress has passed three COVID-19 related bills to address urgent issuesand it is likely more will be considered. The stimulus bills address critical infrastructure, health, and the economy. There are numerous parts to each of these bills; we’ve included highlights on issues we think will impact individuals with autism, their families, and those serving them.  


Direct payments will be sent to US households
:
Note: this law is very new
the IRS is still issuing guidance, and tax experts are still analyzing the law. (As we get updated information, we will add to what we know about the payments). In most cases you do not have to do anything to receive a paymenthowever, in most instances, you must have a valid Social Security number to be eligibleYou can check the IRS COVID-19 page for information as it becomes available.  Below are some of the payment details: 

  • Most adults will get $1,200, but some will get lessdepending on your income. For every child age 17 or under, who is claimed as a dependent on the tax return, there will be an additional payment of $500. There are some exceptions to the dependent payments outlined below.  
  • Payments are typically based on 2018 tax filings (filed in 2019) OR 2019 returns if you have already filed one this year  
  • Payments are sent by direct deposit (if the IRS has that on file). Check payments would come later.  The IRS is setting up a website where you can update your direct deposit information, but as of this writing it was not available.  
  • If you have not filed for 2018 or 2019, you should. Those with low or no income can file for freeThose on Social Security and SSI Disability do not need to file a tax return. Their Social Security Administration data will be used to distribute funds. 
  • This is an advance on a tax credit that will be available for all of 2020: If you don’t get a direct payment, you should be able to claim it in filing taxes for 2020 (in 2021).  
  • You will not get a direct payment if someone claims you as a dependent, even if you’re an adult, so, 18– to 26 yearolds who are still claimed as dependents will not get their own stimulus checks, unless they file their own tax returns for 2019. Parents will get $500 payments for those 17 and under, but it looks like not for 18– to 26 year old adult dependents, but more guidance is expected from the IRS on this soon. The IRS is also still issuing guidance for adults who are on Social Security or SSI and claimed as dependents, (often disabled adults and frail elderly, usually under guardianship). It is not entirely clear at this time how these adult “dependent” Social Security recipients will be treated under the new law; as dependents (who might qualify for $500 added to the household that claims them), or if they will be treated as other adult dependents excluded from the law. We will include more detailed information in our next update, if available. 
  • In any given family and in most instances, everyone must have a valid Social Security number in order to be eligible. Non-resident aliens (US residents without green cards) are also not eligible. If one spouse has a SS number and the other does not, they are ineligible for the spousal payment. (There is an exception for members of the military.). 
  • These payments should include those on Social Security, retired or disabled, unless they are ineligible for other reasons, or claimed as a dependent. Dependents may be included in the household direct payments where they were claimed on tax returns, it’s not yet clear These cash payments will not count as income or resources for a period of 12 months so that people who get means tested federal benefits, like Medicaid, SNAP, housing assistance, will not have those benefits reducedMore information on Social Security Recipients and these direct payments can be found herehttps://www.nationaldisabilityinstitute.org/wp-content/uploads/2020/03/cares-act-and-the-disability-community.pdf 
  • The payments are not taxed as income. And again, they are not counted as a resource for 12 months for means tested federal benefits. 
  • This law is brand new and guidance on it is changing hourly. We will update this info as we know more.  


Some student loan relief will be available: 

  • Interest will not be collected on federal student loans.  
  • Federal student loan payments will be suspended until September 30. Check your statement 
  • Federal Loans in default will not collect payments, including those typically garnished though tax returns. 
  • Loans held by non-federal sources (Private, state, FFEL, Perkins, etc.) are not included. Check with your loan holder for assistance.  

 

Unemployment Insurance options:
More people are now eligible for Unemployment Insurance (UI) programsThe National Employment Law Project has an indepth fact sheet on the unemployment law changesTo file unemployment claims in North Carolina, contact the NC Department of Commerce.

  • People unemployed, partly unemployed, or unable to work due to COVID-19related reasons are more likely to be eligible for unemployment compensation. This includes self-employed and parttime workers who are generally not eligible under the old UI guidelines.  
  • If you are unemployed because you are sick with COVID-19, quarantined, caring for someone sick/quarantined, or are taking care of child due to school closure/childcare closure, you are eligible. 
  • People can file immediately. 
  • People can file via online or phone. Due to high volumes of people filing, there may be some waits on the phone lines. 
  • People do not have to search for work during this emergency. #staysafestayhome 
  • Benefits in NC have not changed, though the federal government has allowed for higher payments and extended unemployment an additional 13 weeksIn NC the Administration and General Assembly are reviewing what must be done to expand our unemployment compensation program from its current payments and timeframe of 12-13 weeks 
  • You are not covered if you quit your job because you fear that continuing to work will put you at risk for contracting the virus 
  • You are not covered if you have unused paid sick leave or family paid leave (can’t double dip).  

 

COVID-19 Paid Sick Leave and Family Medical Leave Changes: 
Congress has passed legislation to authorize 12 weeks of job protected leave to care for at-risk family members in quarantine, to be in quarantine, or to care for a child if there is no school or available childcare. Not all companies are included in the new law, so it may or may not apply to you. We recommend that you check with your employer and/or their human resources department regarding expanded sick leave and FMLA.  

  • The bill requires companies with fewer than 500 employees to offer 14 days of paid sick leave so that people have paid leave from work to get tested, see a doctor, and be quarantined or recover from illness. This paid leave could also be used at 2/3 the rate to care for a sick family member or a child without childcare/out of school. Note that some small companies can request waivers of this requirement. Large companies were not included in the provisions under the idea that they already offer these benefits.  
  • There are tax credits for self-employed individuals related to sick and family leave, as well as the benefits under unemployment insurance outlined above.  
  • Some healthcare providers are excluded from requirements to provide additional leave due to readiness for providing COVID-19related care.  

 

There is increased funding and changes to numerous health care and economic issues related to COVID19. 

  • ASNC is monitoring and working to implement new guidelines in its service programs, as are many I/DD and health care providers.  This is a challenging process and we appreciate your patience as we figure out how to deliver services under new regulations.  
  • The (federal) Center for Medicare and Medicaid Services (CMS) is allowing waivers and changes to services and supports across health care settings so that resources, staff, and services can address the increase in need for COVID-19related care, as well as the changes needed due to social distancing, stay at home orders, closed schools, and closed businesses. These changes are extensive, and we have only addressed a few of them in this update. 
  • CMS/legislation has raised Medicaid funding to states (higher Federal Medical Assistance Percentage (FMAP) payments) in anticipation of added healthcare costs.  
    • Higher FMAP payments are temporary and the higher payments will not necessarily increase the availability of health care to the uninsured (except for COVID19 testing and care) or the availability of services and supports to people with autism (for example, more temporary federal money does not equal more waiver slots). Some state or local funds may be increased or eased up to allow for retention of services and some temporarily available services; we are still waiting to see what will happen.  
    • In North Carolina, LME/MCOs have freed up funding from risk reserves and allowed flexibility in single-stream funds to address COVID-19-related issues in state-funded services. See your local LME MCO for more information.   
    • CMS has allowed changes to how services are delivered under Medicaid and Medicare. North Carolina COVID19 related changes can be tracked on the Medicaid COVID -19 webpage.   
  • Funds increased for Independent Living Centers 
  • The Money Follows the Person program has been extended through November.  
  • Funds increased for hospitals and veterans health caremoney for Personal Protective Equipment (PPE) ventilators and other suppliesfunding for research on the disease, distribution of goods needed for emergency COVID19 health care. 
  • Funding has been increased for small business loans, including to nonprofits and Medicaid service providers, to retain employees and restart businesses (Some I/DD Medicaid providers may not qualify as “small businesses” under federal guidelines.)  
  • Money for key industries is part of the stimulus, but I/DD services and Direct Service Professionals are not included except as outlined above  

 

CMS approved flexibility in serving people in North Carolina on Medicaid and in Innovations Waivers
This will allow wider use of telehealth services during the emergency. It will also allow  flexibility in delivering current services under Medicaid to people with I/DD, including changes to location of services, duration, extensions to plan approvals, allowing family members to provide services, as well as other options so that people who have services and supports can retain them. While the new Medicaid waiver changes specifically apply to Innovations, in North Carolina, this flexibility is going to eventually be extended to statefunded services as well.  

Direct Support Professionals (DSPs) will be allowed to accompany individuals to a hospital if needed. 
This would allow a DSP to continue their role supporting the person during a hospital admission, something that individuals with disabilities, who may not always be able to see to their own needs/supports, could not access when hospitalized. This brandnew provision, originally part of another bill, will allow organizations to be reimbursed for direct support professionals who accompany someone to support that person while hospitalized. Because hospitals are limiting access to all individuals who accompany someone, including family, due to COVID-19, the hospitals current rules about safety and accompanying someone would likely affect this lawThis means that DSPs ability to accompany someone could be limited in the same way by a specific hospital due to COVID-19 infection concerns: not allowed, restricted based on health status, or otherwise limited depending on hospital policy about who is allowed in with the patient.   

The newest bill includes protections of the rights of a free and appropriate education, rights under ADA, IDEA, and other disability rights protections during this time. A statement from the Department of Education can be read here We do not yet know how Local Education Agencies (LEAs or school districts) in North Carolina will address the education of students with IEPS, 504s, and other pending disability assessments.  ASNC is advocating with the NC Department of Public Instruction and school systems for students to receive equitable education but also recognize that certain services and programs may need to find innovative approaches to educating students. We are advocating at state and national levels for additional funding and flexibility (without a loss of rights) to address these issues. Wrightslaw has provided some answers and guidance on access to education during this emergency here.

Questions about this or other public policy issues? Please contact Jennifer Mahan, Director of Public Policy, at jmahan@autismsociety-nc.org.

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