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SB 246

An Act amending the act of March 10, 1949 (P.L.30, No.14), known as the Public School Code of 1949, in student supports, providing for parental and employee notification of weapon incidents.

2025-2026 Regular Session Introduced by Dave Argall and 7 co-sponsors

Expands NC Innovations Waiver by adding 10,000 slots over 2 years with state funding and federal match to cut I/DD waitlists and generate about 13,000 local jobs.

Act No. 44 of 2025
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WeVote Research Nonpartisan
Bill Summary · SB 246

SB 246 — “Create 13,000 Jobs Serving People With I/DD”

Status: Passed 1st Reading. Introduced: Jan 30, 2025.

Main purpose

Expand access to North Carolina’s Innovations (Medicaid) Waiver for people with intellectual and/or developmental disabilities (I/DD) by adding waiver slots and state funding so more individuals on the waiting list can receive community-based supports. The bill is framed also as an economic development measure: researchers estimate each new waiver slot generates ~1.3 local jobs, so the bill’s slot increase would create roughly 13,000 direct and induced jobs.

Key provisions

  • Appropriations (recurring General Fund):

    • FY 2025–26: $134,000,000 (state share)
    • FY 2026–27: $357,340,000 (state share)
    • These state amounts are intended to draw federal Medicaid match:
    • FY 2025–26 federal match: $244,750,000
    • FY 2026–27 federal match: $652,660,000
    • Federal funds appropriated to DHB for implementation.

  • Waiver slot increases:

    • FY 2025–26: Add 5,000 Innovations Waiver slots (to be made available Oct 1, 2025, unless delayed by CMS approval).
    • FY 2026–27: Add 5,000 additional slots (to be made available July 1, 2026).
    • All slots to be filled on a first‑come, first‑served basis according to length of time on the Innovations waiting list.

  • Allocation and acceptance procedure (first tranche):

    • DHB will distribute slots using the existing allocation formula (as of the bill’s effective date).
    • Each LME/MCO has 30 days to accept some, all, or none of the slots offered.
    • Any rejected slots are redistributed equally among LME/MCOs that certify:
    • Rates paid to providers are sufficient to pay direct‑care employees at least $20/hour (the LME/MCO may reflect legislatively designated wage supplements in rates); and
    • They have the ability/capacity to provide services in their catchment area.
    • An LME/MCO’s election to accept/reject slots in 2025–26 does not affect distribution of 2026–27 slots.

  • Implementation and oversight:

    • The Department of Health and Human Services, Division of Health Benefits (DHB) is responsible for waiver amendments, distribution, and claiming federal match.
    • All actions subject to any required CMS approvals.

Who is affected

  • Primary: Individuals with I/DD on the Innovations Waiver waiting list (≈19,000 at time of drafting).
  • Service system: LME/MCOs, community providers, direct support workforce.
  • Workforce: Direct care workers (explicit $20/hour wage floor requirement for accepting redistributed slots).
  • State Medicaid administration (DHB) — responsible for implementation and CMS coordination.
  • Employers/local economies — expected job creation and economic activity in local communities.

Timeline & procedural notes

  • Effective date: provisions take effect July 1, 2025 (waiver slot availability dates as above).
  • Slot availability in Oct 2025 may be conditioned on obtaining CMS approval for waiver amendment and the slot acceptance/redistribution procedure.
  • DHB must use current allocation methodology unless CMS disallows the proposed acceptance/rejection redistribution approach.

Fiscal and program impact — summary

  • State recurring appropriations: $134.0M (FY26) + $357.34M (FY27).
  • Federal match estimated: $244.75M (FY26) + $652.66M (FY27).
  • Programmatic impact: immediate expansion of community waiver capacity for up to 10,000 additional beneficiaries across two years; expected to reduce waiting list growth and enable family caregivers to re-enter workforce.
  • Economic effect (per cited academic analysis): each waiver slot ≈ 1.3 jobs created locally; $1 state investment in direct care plus federal match yields ~ $5 of local economic activity.

Considerations / risks

  • Implementation depends on CMS approval of waiver changes and on provider capacity to scale services quickly.
  • Wage requirement tied to redistribution may influence where slots are ultimately deployed.
  • The recurring nature of the appropriations commits future state budget capacity for ongoing slot funding and federal match.

Compiled from official sources — confirm details with the bill’s official record.

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