Advocacy at
The Arc of North Carolina

The Arc of North Carolina is an advocacy and service organization working with individuals with intellectual and developmental disabilities (IDD) and their families for over 65 years. The Arc is committed to securing for all people with IDD the opportunity to choose and realize their goals of where and how they live, learn, work, and play.

The state budget must provide a stable system of care, support, and opportunity for people with IDD across the lifespan. The budget must reflect a cohesive system of comprehensive services that provide options to individuals and families, streamlines regulatory requirements for providers, and maximizes funds by leveraging state and federal matching dollars through waivers and other tools. Most of the goals included in this document are affected by funding/budgeting in some way; however, here are specific budget items.

WORKFORCE DEVELOPMENT AND COMPENSATION

North Carolina does not have enough direct support professionals for people with IDD. Families are in crisis due to lack of support. All 100 counties in North Carolina have experienced increases in the population over 65 years old. The need for direct care workers to provide Home and Community Based Services (HCBS) is expected to increase dramatically over the next decade, with more than an additional 20,000 needed positions expected by 2028.  Projected total job openings for direct care workers in NC by 2030 is estimated at 182,400. There must be an immediate and concrete plan for short term and long-term solutions for a trained and qualified direct care workforce.  Without a competent workforce, there will not be capacity to serve all eligible individuals and families.

• Create a rate structure for Medicaid and State funded services, that allows for a cost-of-living increase (COLA) annually for service providers in all levels of the service system.
• Amend the NC Innovations Waiver to allow individuals under 18 to work in entry-level positions, as apprentices or as interns.
• Create a workforce pipeline that engages K-12 and higher education with training medical, behavioral, and habilitative employees across North Carolina.
• Expand integrated employment across the state.
• Increase funding to provide a career path and training for direct support professionals.
• Establish a statewide, standardized certification process for Direct Support Professionals such as the WE CARE Initiative, of which The Arc of NC supports.
• Support H.R. 4779 (S.1437) Recognizing the Role of Direct Support Professionals Act .

Push Congress to revise the Standard Occupational Classification system to establish a separate code for DSP classification that will recognize DSP as a workforce.

• Establish a “years worked in lieu of education” equivalent for Certified DSP and Qualified Professional staff.

NC INNOVATIONS WAIVER

• Fund 25% of the NC Innovations Waiver waitlist (Registries of Unmet Needs) annually until no one remains on the RUN.
• Need improved and inclusive collaboration from state leaders working with stakeholders on IDD issues.
• Include Tenancy Support as a stand-alone service in the waiver as well as in other service arrays and funding streams, to provide assistance as needed for people to become successful living as independently as possible.
• Ask Legislature to direct NC DHHS to allow family to become Relative as Provider for individuals under the age of 18.
• Establish emergency respite and housing funding through the Innovations Waiver.
• Explore the possibilities of using NC START to utilize existing housing assets.

GUARDIANSHIP

Many individuals with IDD and severe/persistent mental illness in North Carolina require some level of guardianship and do not have a family member to provide this vital support. The Arc is a nonprofit corporate guardian to over 780 people with IDD or severe/persistent mental illness and supports an individualized approach to guardianship, emphasizing the least restrictive level of guardianship, alternatives to guardianship, and active restoration of rights whenever possible. Guardianship also requires counties and the court system to be consistent.

• Increase the corporate guardianship rate to $325 per individual per month to keep balance between Guardianship and Care Management wages, for similar skill
• Establish consistency in applying guardianship statutes protocols, with training and compliance requirements for Clerks of Court.
• Provide training for educators, social workers, and those working with impacted families.
• Direct North Carolina DHHS to maintain control and management of corporate guardianship contracts.

Group Home Stabilization. Added $10 million recurring each year of the biennium for group home stabilization

Supplemental short-term assistance for group homes. $1.8 million supplemental short-term assistance for group homes

Increase Innovations Waiver slots by 1,000 to help reduce the Registry of Unmet Needs (RUN). The final budget includes 1,000 Innovations Waiver slots.

Directs DHHS to develop a plan for adequate provider supply for services provided through the Innovations Waiver.

Continue Medicaid eligibility to twelve months postpartum for new moms.

Resume funding for adult and pediatric TBI pilot.

Increase rates to ICFs for direct care worker wages.

Increase rates to HCBS providers to increase direct care worker wages.

Increase private duty nursing rates.

$25 million in nonrecurring funds to establish the Children with Disabilities Reserve. 

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