When Government Listens to the People

June 2016

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By Tom Vitaglione, Senior Fellow, NC Child

NCC_Legislation Banner_5Our government works best when policymakers listen to their constituents and are willing to change course as a result of what they’re hearing. This happened recently in Raleigh in a situation affecting hundreds of families with fragile disabled children who need a lot of help. Several weeks ago the NC Division of Medical Assistance published proposed policies to alter the Community Alternatives Programs that provide special Medicaid coverage and benefits for both adults and children with medically fragile conditions. The stated purpose was to merge and streamline the programs.

But it turned out that when parents and advocates of these children analyzed the proposal, the proposed changes would potentially restrict access to the programs, and would certainly significantly reduce the critical benefits that are necessary to allow the recipients to remain under care at home, rather than in institutions.  (And institutional care costs far more than keeping these children at home.)

Parents who talked to WRAL TV told how the changes would have forced them into unthinkable situations—a single mother would have had to choose between the job that sustains her and her daughter, and caring for her daughter.  Another family would have had to leave their home.

And the parents spoke out—they and professional organizations, providers, and advocacy groups sent in more than 400 comments to the Division. The majority of the comments were from families– families who have dedicated themselves and made enormous personal sacrifices to keep their affected family members in their homes. There were many stories that were both heroic and inspirational. Despite their long hours of providing care for their children, they somehow found the time to write to the Division to express their serious concerns. For this, they should be especially commended.

Then, in an illustration of responsive government, Division officials analyzed all comments carefully, and have announced that the proposed policy changes are being withdrawn. They will be reconsidered in light of the comments, and what the Division termed “stakeholders” will be involved during the period of reconsideration.

While state agencies are required to invite comments on proposed policy changes, they are not required to change direction based on those comments. In fact, they often don’t. Thus, the staff and leadership of the Division of Medical Assistance should be commended for listening carefully and agreeing that the proposed policies might result in unintended negative outcomes for some of the most vulnerable North Carolinians. This is an example of  responsive government at its best.