The North Carolina Department of Health and Human Services and the Office of Disability Rights have agreed to a plan aimed at providing more people with disabilities the support they need to live in the community.
The agreement is a proposed consent order that emerged from mediation and negotiations in a case known as Samantha R.
Disability Rights NC sued the state Department of Health and Human Services in 2017, alleging it doesn’t provide enough community and in-home services to help people with intellectual and developmental disabilities leave or avoid institutional life.
The proposed consent order announced Wednesday replaces a comprehensive court order issued by Judge Allen Badour in November 2022, which included a 10-year timeline for eliminating the community service waiting list, which has grown since November 2022 from about 16,000 people to more than 17,500 as of December 2023. The agreement announced Wednesday does not call for eliminating the waiting list.
DHHS said the requirements Governor Baddour outlined for 2022 were unrealistic. The state appealed the order. The two sides asked the appeals court to mediate last summer.
As a result of the new agreement, DHHS dropped its appeal and the Disability Rights Association agreed to a compromise. Badour is scheduled to hold a hearing on the proposed order next week.
The bill lays out the actions DHHS will take over the next few years to transfer people out of institutions. DHHS will also have to ensure that local mental health offices, called local management agencies/managed care organizations, maintain adequate provider networks. LMEs/MCOs will be responsible for paying home- and community-based service providers.
LMEs will face stricter standards regarding provider suitability.
Under the agreement, DHHS will move at least 249 people out of institutions and into community-based settings by June 2027.
The state faces a shortage of direct care workers who provide services to people with disabilities. They are underpaid and have few opportunities for advancement. A study released earlier this year found that direct care workers’ median hourly wage in 2022 was $13.62. In 2021, 17% did not have health insurance.
Recommendations from the North Carolina Community Health Education Center on expanding the pool of direct care workers are incorporated into the agreement.
“We are grateful for our partnership with DRNC that enabled us to reach this agreement so we can do the right thing for North Carolina people with intellectual and developmental disabilities,” Kelly Crosby, director of the Department of Mental Health, Developmental Disabilities and Substance Use Services, said in a statement.
The disability rights group said in an email that the order does not end the litigation. In a written explanation of the consent order, the disability rights group said the parties will meet in two years to recommend next steps. The state could seek to end the litigation or the court could issue additional orders.
“This proposed agreement is the beginning of change, not the end,” Emma Kinyanjui, legal director for Disability Rights NC, said in a statement. “Working together, DRNC and NCDHHS will focus on making changes now, making sure the system is trending in the right direction, rather than spending time and focus on appeals over the next two years.”