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June 2017: Highlights and Hot Topics


 A Message from Our Executive Director

June has been a busy month, and in addition to our day-to-day efforts working with community partners, we have all been focusing on the federal level as fundamental changes to Medicaid, a lifeline for many people with intellectual and other developmental disabilities (I/DD) and families, are being considered. The Congressional Budget Office (CBO) score shows that the Senate’s Better Reconciliation Act, like the House-passed bill, would create deep cuts in the Medicaid program, and impact state’s abilities to provide services.

This is a critical time. We will continue doing our best to inform and educate. Our National Association of Councils on DD along with our NC policy team remain very active and we will continue providing updates to you from Washington, DC. But, it’s important, as citizens of North Carolina, for you to inform and educate members of Congress about your Medicaid story.

Now, shifting our focus a bit, here in North Carolina the new two-year budget has been passed by the NC General Assembly after a veto by the Governor which was overridden in the House and Senate. This budget includes money for the Disability Rights North Carolina settlement; expands the Innovations Waiver slots; and addresses other important supports for individuals and families. More information about the budget is provided in the public policy section below.

During this last quarter, we also welcomed a new Council member, Myron Gavin, from Craven County as a parent advocate! We are excited to have Ms. Myron Gavin on board as the Council moves ahead with its Five Year State Plan. You can learn more about Ms. Gavin in the member spotlight section of this edition of our monthly Highlights and Hot Topics.

As always, we love hearing from the community about your thoughts, events and even your ideas on what can make your community a more inclusive place to for people with I/DD to live, work and play. Contact us here.

Chris Egan
Executive Director

Public Policy Update

NCCDD’s public policy team brings a comprehensive update on federal and state public policies that affect people with disabilities and their families.

State Budget Highlights - The budget developed by the conference committee was approved by the legislature. It was sent to the Governor for signature and the Governor vetoed. It was sent back to the legislature, where the veto was overridden. The budget will be certified by the Office of State Budget and Management and issued to each agency. Below are a few highlights:

DRNC Settlement: to build services for children with I/DD and behavioral health needs through assessments and services, including home health, rehabilitative services, personal care services and an outpatient clinic at Murdoch Center.
SFY17-18 $6.22 million R $26,914 NR
SFY18-19 $6.28 million R

Expand I-DD Innovations Waiver slots by 400 slots by January 1, 2018
SFY17-18 $4.1 million R
SFY18-19 $8.3 million R

Group Home Funding
SFY17-18 $5 million NR
SFY18-19 $5 million NR

Adult and Pediatric Traumatic Brain Injury Pilot: Three program sites will be selected by DHHS to develop and implement an interactive quality assessment and quality assurance clinical decision support tool to provide real-time, evidence-based medical care guidance for intensive care unit patients with severe adult or pediatric traumatic brain injury.
SFY17-18 $150,000 NR
SFY18-19 $300,000 NR

Adds to the Strategic Behavioral Health Plan an analysis of the I-DD service system as it relates to the waitlist for I-DD services, expansion of Innovations Waiver slots, feasibility of creating a Section 11F.6.(a)-(b) 5 supports waiver or a 1915(i) waiver, issues around State funding for individuals with I-DD, and other federal initiatives.

Increases Personal Care Services rate beginning for services occurring after December 31, 2017.
SFY17-18 $1.3 million R
SFY18-19 $2.7 million R

A more comprehensive report of the budget, as well as an update on other legislative action, will be provided once the legislative session is over.

Federal Policy Updates

Impact on Medicaid

Like the House bill, the US Senate’s Better Care Reconciliation Act maintains a cut and cap to the Medicaid program. Analyses show that North Carolina may lose a minimum of $6 billion dollars in Medicaid funds. In the event of this anticipated funding shortfall, the State would likely need to cut benefits to close that gap. Cuts could include:

  • Changes to Medicaid eligibility, meaning who receives services now may change
  • Limiting Medicaid service array, meaning that certain services currently covered may no longer be available
  • Cutting service quantities or reimbursement rates
  • Home and Community Based Waiver Services (HCBS) will be particularly at-risk given they are "optional" for states to provide, and are a significant investment

Next Steps: The vote has been delayed until after the July 4th recess, which runs from July 1-9, 2017. Congress will be back in their respective districts.

Your Opportunity: We, as a community, must become resources to our Senators and their staff. The Medicaid program, as it relates to I/DD, is often misunderstood by many who do not use these critical supports. As a community member, self-advocate, a family member, caregiver, you can talk about the impact of Medicaid and how the Medicaid program:

- Is often the only payer of long term services and supports which allow qualifying individuals to live in their community with loved ones and away from costly, segregated institutional settings.
- Allows many families to stay in the workforce while their son or daughter receives professional supports in the community.
- Supports individuals with disabilities to find and maintain employment and achieve many other important life outcomes.
- Employs thousands of professionals across our State.

Remember to inform and educate. But, call as an individual citizen and express any preference that you choose.

To call your Member of Congress:
US Capitol Switchboard: (202) 224-3121

To locate your Member online:
U.S. House of Representatives: www.house.gov
U.S. Senate: www.senate.gov


NCCDD Attends Spring Policy Forum

The NC Council of Community Programs Spring Policy Forum held in Raleigh, NC on June 4-5 offered a clearer understanding of state and federal policy changes within Medicaid with presentations by North Carolina and national leaders. Sessions at the forum revolved around how to implement key business and clinical practices to ensure the ability to compete in a changing healthcare environment.

North Carolina Council on Developmental Disabilities (NCCDD) was represented by Council member I. Azell Reeves, former Council member Jonathan Ellis, Council staff Melissa Swartz, Philip C. Woodward and Chris Egan, NCCDD’s executive director.

The opening session on leading collective impact was led by Paul Schmitz, CEO of Leading Inside Out and senior advisor to The Collective Impact Forum. NCCDD has adopted the Collective Impact model to evaluate the success of its current Five-Year State Plan and plans to incorporate the model into each initiative going forward.

Chuck Ingoglia, senior vice president, Public Policy and Practice Improvement, for the National Council for Behavioral Health, spoke about national changes to Medicaid and other federal initiatives.

“In this session, he discussed the changes that the proposed American Healthcare Act (AHCA) would bring to Medicaid. He shared the Congressional Budget Office’s estimate that, under the act if signed into law, 14 million Americans would lose their health insurance in 2018,” shared Woodward. This includes six million in the individual market, five million in Medicaid and two million in the commercial market.

Ingoglia also shared federal advocacy goals targeted at educating young Congressional staff who do not fully understand the system of services for people with intellectual and developmental disabilities (I/DD) and mentioned that October 2-3, 2017 will be Hill Day for the National Council for Behavioral Health to educate and inform federal legislators and their staff.

Following the first day’s presentations, attendees viewed “Bottom Dollars”, an original documentary highlighting the effects of the federal law and practice of paying individuals with intellectual and developmental disabilities subminimum wages.

“The movie profoundly impacted me and reinforced the talents and skills that people with I/DD can contribute to a business in the community rather than being paid a very low wage in a sheltered workshop. I believe this film can help create higher expectations for what people with I/DD are capable of doing,” added Woodward.

Closing the forum on Tuesday, while speaking on the North Carolina Healthcare System: A Vision for the Future, was Mandy Cohen, MD, MPH, Secretary, NC Department of Health and Human Services (DHHS). She shared DHHS’s current three areas of priority:
1. The opioid crisis
2. Medicaid reform
3. Investing in early childhood intervention and health

Woodward stated, “These priorities, combined with the Collective Impact model, help me see how the work that NCCDD does fits into the work that DHHS is currently doing and to understand how to maximize the positive impact that each NCCDD initiative can have in helping NCCDD achieve its Five-Year State Plan goals and objectives to help North Carolinians with I/DD lead more independent, meaningful lives in their communities."

Council Member Spotlight: Myron Gavin

Myron Michelle GavinMyron Michelle Gavin works as a middle school exceptional children’s teacher for Craven County Schools, collaborating with general education teachers to provide accommodations and make learning accessible in the general education classrooms. In addition, she provides intervention instruction in Math and Language Arts. Gavin is also a new member on the North Carolina Council for Developmental Disabilities (NCCDD).

She is an advocate for people with disabilities and is raising a 16-year old daughter who is on the Autism spectrum. “Between my experiences in acquiring services and activities for her, coupled with the struggles and celebrations I have experienced in the school settings, I feel that those that can’t always speak need a voice,” shares Gavin. She also feels strongly that everyone needs to promote inclusion by educating others on the various disabilities so they realize they should dwell on possibilities instead of having low to no expectations.

Armed with a bachelor’s degree in Family and Consumer Science from UNC-Greensboro, an associate’s degree from Craven Community College in Early Childhood Education, and certified in K-12 Adaptive and General Education and Pre-K, Gavin is working on a graduate certificate in Autism. She was a member of the 2014 Partners in Policymaking leadership and advocacy training, a program that was funded by NCCDD.

She carries her spirited attitude into additional work outside of her job as a Girl Scout leader for the North Carolina Coastal Pines-Enchanting Waters Service Unit and is the managing director of Hour Special Place, a nonprofit specializing in providing respite, education and activities for families and individuals with special needs.

Gavin is hoping the Council will focus on employment and training for individuals with disabilities, finding appropriate partners and support for this cause. As she continues to advocate for people with disabilities, she finds dispelling the misconceptions of disabilities and letting people know that not all disabilities are visible, are her biggest challenges.


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North Carolina Council on Developmental Disabilities

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