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Public Policy and Legislative Update: The First Few Weeks Have Mostly Been About the Budget

North Carolina State Legislative Office Building

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November’s elections swept more than 40 new legislators into office and put Republicans in control of both chambers of the North Carolina General Assembly (GA) for the first time in over 100 years. The new leadership of the House and Senate hit the ground running in late January during the first week of session with committee structures in place and revised rules for each chamber ready for discussion and vote. Leaders of both chambers have repeatedly said their priorities are jobs, the economy, and filling the state’s budget gap (previously estimated at $3.7 billion, now estimated at $2.4 billion). GA Leaders have also said to expect budget cuts, but have not specified what might be cut.

One of the first bills working its way through the General Assembly is Seante  Bill 13, the Balanced Budget Act of 2011. This should not be confused with the budget bill, which will be introduced later in the session.  HB 13 gives the Governor and General Assembly authority to take unused funds from this budget year to help offset next year’s budget gap. So far no funds have been removed from agencies that work with developmental disabilities, mental health, or addictive disease.  However, earlier this year the Governor asked that funds be held back in anticipation of a potential gap.  The holdback amount has been increased to 5% of state agencies’ budgets, which may be taken in the final quarter of the fiscal year, April through June.

Yesterday Governor Purdue released her budget proposal for fiscal years 2011-2012 and 2012-2013. In positive news for the autism community, the proposal contains no cuts to developmental disability service funds, very minimal cuts to Medicaid and $75 million dollars for the Mental Health, Developmental Disabilities and Substance Abuse Trust Fund. In order to fill the estimated $2.4 billion dollar budget gap and protect her stated priorities of job development, education, and mental health, the Governor has proposed no new programs. Instead, the budget proposal consolidates state government agencies, eliminates 10,000 state positions (3,000 are estimated to be currently filled) and proposes a revenue package that reduces the state corporate tax while keeping much of the increased sales tax. Overall, this is good news for people with Autism Spectrum Disorder. You can email the Governor to thank her for protecting core services for ASD.

The General Assembly may take the Governor’s budget as a starting point. However, given that the Governor is from the Democratic Party and the General Assembly majority is from the Republican Party, it seems likely that the GA will have its own set of budget priorities. North Carolina is required to have a balanced budget.  General Assembly leadership has stated the House and Senate are working closely together in preparing their budgets. The House expects to finish their budget by April and the Senate by June 1.

The legislative committees which determine the budget for many of the programs that serve people with Autism Spectrum Disorder are the House and Senate Health and Human Service (HHS) Appropriations Committees. HHS Appropriations oversees the NC  Department of Health and Human Service’s entire budget including Medicaid and the Division of Mental Health, Developmental Disabilities and Substance Abuse Services which provides funds to Local Management Entities.  Appropriations committees have been meeting jointly every week, initially to educate new HHS appropriations committee members with presentations on state HHS agency budgets and programs. Next they will look at the HHS budget and make recommendations for agency and program budget allocations. Appropriations committees are typically given a targeted amount of funds they can allocate by the “big” appropriations chairs (the chairs of the overall appropriations committee). In good years, the target would include funds to expand successful programs and/or create new ones. But with the current budget gap the target is likely to be an amount to cut.  

It’s not been all about the budget these past three weeks; in addition to advocating for budget decisions that support people with ASD, the Autism Society of North Carolina is tracking a number of bills including legislation to support better residential options, revise the DD waiting list, allocate DD resources, report on utilization management of CAP MR/DD, and several bills that could impact confidentiality of MHDDSA records and voting for persons with disabilities. There will be more information on legislation to watch in the next Public Policy Update.

Visit the Office of State Budget and Management  to look at the Governor’s Budget proposal in full.  Warning before you print – the summary is more than 300 pages and the supporting documents are several thousand pages long!

Go to the Legislative website to find details on your legislators, committees (including information presented to members by staff) and introduced bills, as well as other legislative information.


4 Responses

  1. Thank you for this very informative summary. What is the status of the autism insurance mandate? To me that is a critical piece of legislation that we cannot let go. Especially because it is not too costly for the state budget, I feel hopeful.

    • Kristine – The autism insurance bill has been re-introduced this session as Senate Bill 115. ASNC and other advocates are working on introducing a bill in the House as well. It is critical. Getting diagnosed and treated means better outcomes in the future, and for Legislators and the state that translates to savings in the long run. I don’t want to sugar coat the situation; Legislators are reluctant to support any bill that impacts the state budget or is perceived to impact short term health care costs. We are counting on advocates like you to inform your elected officials about autism spectrum disorder and how important treatment, and insurance coverage for treatment, is to you.

  2. I am glad to hear it is still on the radar. I know financial impact studies were done. In my son’s case, the insurance mandate passing would actually SAVE the state money, even in the short term. I wonder how many other individuals are like him. He is eligible to get BCBS through his father’s work (UNC hospitals ironically) but they won’t pay one dime toward his treatment. Then my son also has medicaid which DOES pay for his therapies- currently SLP, OT, PT. If BCBS was mandated to pay for these evidenced based medical treatments, then medicaid would not have to. Private insurance is always the primary payer . Right now, they just reject all the claims, medicaid then pays.

    • We wonder too how many people would be covered by insurance, rather than state or Federal funding if insurance standards in North Carolina were set to include services for ASD. Thank you for sharing your story with us – this helps us make the argument for better standards to legislators!

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