Legislative/Policy Initiatives

Legislative & Policy Initiatives

2021 NC Providers Council Legislative Priorities

In 2020 and 2021, the COVID-19 pandemic required NCGA Members and their constituents to modify communications and meeting venues. However, the Providers Council has continued to work through its contract lobbyists, John Metcalf and John Broome of The Policy Group, and Peyton and Joel Maynard of Maynard and Associates.  Working in tandem with the Providers Council Board and standing Committees, the lobbyists have ensured that the Providers Council’s legislative priorities are communicated to key Committee Chairs and Members during the 2021 Long Session.

The NC Providers Council has a great reputation for its analysis of legislation, administrative rules, and Medicaid State Plan, waiver, and clinical coverage policy provisions impacting community services funded through the North Carolina General Assembly and North Carolina Department of Health and Human Services (DHHS). With our active involvement at the General Assembly through The Policy Group and Maynard and Associates, collaboration with numerous Divisions of DHHS – including participation on statewide workgroups and Committees, and an ongoing, constructive dialogue with Standard Plan and LME/MCO leadership, the association advocates for providers and the people who we support.

Legislative Session bill trackers, legislative summaries, and other documents related to NC Providers Council legislative advocacy are posted on the password-protected Member Communications page. 

OLMSTEAD UPDATES

Olmstead v. L.C., 527 U.S. 581 (1999), is a U.S. Supreme Court case that laid the groundwork for people with disabilities to live their lives as fully included members of the community. The case addressed the Americans with Disabilities Act’s (ADA) “integration mandate.” The integration mandate requires that all public entities, including the State of North Carolina, “administer services, programs, and activities” for people with disabilities in the most integrated setting appropriate to the person’s needs. “Most integrated setting” has been defined as one that enables people with disabilities to interact “to the fullest extent possible” with individuals that don’t have a disability. Specifically, the case requires states to provide services in the community for eligible persons with disability when (a) such services are appropriate; (b) the affected persons do not oppose community-based treatment; and (c) community-based services can be “reasonably accommodated.”

The State Of North Carolina is developing a long-range plan for future Olmstead compliance. Legal and policy advisors have asserted to DHHS that the best way to protect against further lawsuits is to have a comprehensive state plan that outlines what the state aspires to do in order to create choice and opportunities for the broad range of persons with disabilities. Importantly, in addition to the plan, the state must also have the funding and resources allocated to execute the plan. The Office of the Senior Advisor for the Americans with Disabilities Act (ADA) and Olmstead will lead this 18-month initiative. NCPC Board Vice President Wilson Raynor serves on the Advisory Group on behalf of NCPC.

For additional information, please visit the NC DHHS Web page that includes Olmstead Plan documentation and Stakeholder Advisory meeting information.

 

QUALIFIED PROFESSIONAL EDUCATION WAIVER HISTORY AND STATUS

  • In 2013, the General Assembly enacted N.C.G.S. 108A-54.1B. to give DHHS State Plans and Waivers the force and effect of rules.  Part (d) of that statute reads, “State Plans, State Plan Amendments, and Waivers approved by the Centers for Medicare and Medicaid Services (CMS) for the North Carolina Medicaid Program and the NC Health Choice program shall have the force and effect of rules adopted pursuant to Article 2A of Chapter 150B of the General Statutes.”
  • In 2017, Session Law authorized an expansion of Qualified Professional hiring qualifications to include pre-education work experience in addition to post-education work experience.
  • In 2018, the Centers for Medicare and Medicaid Services (CMS) approved this North Carolina Medicaid program State Plan Amendment to “allow all years of both pre-graduation and post-graduation full-time MH/DD/SAS experience to apply to the qualifications required for MH/DD/SAS Qualified Professionals.”  The 2018 State Plan Amendment has the force and effect of rule [“NC Administrative Code”].
  • In 2019, DMH/DD/SAS promulgated temporary administrative rule amendments to 10A NCAC 27G .0104 and 10A NCAC 28A .0102 to reflect the 2017 Session Law.  However, the temporary rule amendments expired within six months.  The content linked here is for historical reference only. If you open the two rules today, they will be in their original form and will not reflect the 2017 Session Law.  However, because the 2018 State Plan Amendment has the force and effect of rule, the hiring practice of applying both pre- and post-education experience for Qualified Professionals is still authorized.
  • In 2020, DMH/DD/SAS obtained Commission on DMH/DD/SAS approval for a “rule waiver” since the temporary rule amendments had expired.  The rule waiver expired on 12/31/2021.
  • In 2022, DMH/DD/SAS obtained approval for a new rule waiver request.  The renewed rule waiver will expire in 12/2023.  The rule waiver gives DMH/DD/SAS until December of 2023 to complete the permanent (versus temporary or emergency) rulemaking process so the administrative rules can finally reflect the QP qualification changes authorized in the 2017 Session Law and in the 2018 Medicaid program State Plan Amendment.

 

NORTH CAROLINA GENERAL ASSEMBLY QUICK LINKS

  • Click here to access NCGA Session Laws enacted during the 2021 long session.
  • North Carolina General Assembly Home Page with Daily House and Senate Calendars for The 2021 Long Session  http://www.ncleg.net/
  • NCGA Member Directory

 

2021 NC Providers Council Statewide Committee and Workgroup Participation

  • Mental Health Coalition
  • Developmental Disabilities Consortium
  • Substance Use Disorder Federation
  • The Coalition
  • Provider-LME Leadership Forum
  • DHHS/LME/Provider Steering Committee
  • DHHS TBI Waiver Workgroup
  • Statewide Direct Support Workforce Crisis Work Group Member
  • *Some members also serve on LME/MCO Provider Councils and Boards