BAC Minutes_20260505_Draft

DRAFT

NC Medicaid Beneficiary Advisory Council (BAC)

Meeting Minutes
May 5, 2026
Virtual Meeting

BAC Members present:

Jonathan D’Angelo, Crystal Foster, Jenny Hobbs, Hannah Elliott, Marie Britt, Jessica Aguilar, Hannah Steer, Kadee Primus, Gwynneth Wildcatt, Ada Elizabeth Gil Jimenez, Annette Smith, Michael Madden, Matthew Potter, Bee Thao, Janet McDaniel

NC Medicaid Staff present:

Melanie Bush, Kathy Batton, LaQuana Palmer, Sarah Gregosky, Gina Hamilton and a host of other staff members attended via Teams

Kathy Batton welcomed members to the BAC meeting. Opening remarks were given by BAC Chair, Jenny Hobbs. A motion was made to approve the minutes from the last meeting. The motion passed. Jenny Hobbs called meeting to order and roll call was taken by Jennifer Platts.

Sarah Gregosky, Chief Operating Officer for NC Medicaid, provided an updated overview of H.R.1 explaining the impact and the federal changes to Medicaid. Sarah started by providing details about the changes coming for non-citizens and explained notices will be sent to those who will be affected. Local Departments of Social Services will do outreach to all those individuals to ensure we have their most recent information. Sarah shared Medicaid anticipates for those individuals to apply for Emergency Medicaid since they would no longer be eligible for full Medicaid.

Sarah gave BAC members an opportunity to ask questions regarding how non-citizens would be affected by H.R.1. Questions were asked regarding county outreach for those affected, clarification regarding specific immigration statuses, and an update on how the local Departments of Social Services will handle the increased workload.

Sarah continued her presentation by explaining changes coming to retroactive coverage. Starting January 1, 2027, it will be shortened from three months to one month prior to the month of application for most adults ages 19 through 64 without disabilities for. For children, adults age 65+ and individuals with disabilities retroactive coverage changes to two months prior to the month of application

Sarah continued to present work and community engagement requirements, which will only apply to most adults ages 19 through 64 without disabilities (also known as Medicaid expansion) . BAC members had an opportunity to ask questions.

Kathy Batton shared changes made to the Appendix for the Medicaid application and asked members to provide recommendations and feedback on the layout, suggestions on making it easier to complete the form and simplifying terms and words to make them easier to understand.

Members provided feedback and suggested having a video that gives more information on completing the appendix, asked clarifying questions regarding work requirements for FNS and TANF. Gina and Sarah explained that not all exceptions are the same for FNS versus TANF versus Medicaid. Additional questions were asked regarding caregivers, Sarah suggested providing examples once Medicaid receives guidance from Centers for Medicaid & Medicaid (CMS).

Melanie Bush introduced herself as the new Deputy Secretary for NC Medicaid and provided high level Medicaid updates. Melanie announced the rebase was passed last week in House Bill 696, which appropriates the remaining $319 million Medicaid had been asking the General Assembly for since this time last year.

  • The $319 million appropriation came from the Medicaid Contingency Fund on a one-time basis.
  • The contingency reserve previously contained approximately $900 million.
  • Approximately $500 million was redirected to Helene recovery efforts.
  • Following the additional $319 million allocation, approximately $180 million remains in the reserve.

Members expressed concerns that the limited reserves could create challenges if:

  • An economic downturn occurs
  • Medicaid enrollment increases
  • Program costs rise unexpectedly

Chrissy Jackson, Deputy Director for Budget, presented an overview of Medicaid spending through March (Quarter 3) of State Fiscal Year 2026.

Total Budget Utilization

  • Medicaid has expended approximately $28.8 billion of the $34.1 billion total budget through March.
  • This represents approximately 84% of total funds expended.
  • State general fund appropriations were approximately 78% expended during the same period.
  • The figures presented do not yet include the additional $319 million non-recurring appropriation previously referenced by Deputy Secretary Melanie Bush.

Chrissy Jackson emphasized the importance of optimizing services for high-cost populations to maintain long-term Medicaid sustainability and concluded the presentation by inviting questions from committee members regarding Medicaid funding and expenditures.

BAC Chair, Jenny Hobbs shared a survey was to the BAC members asking them for their top three areas of interest for the BAC. Below are the results.

H.R. 1

  • What counts as volunteer hours for work and community engagement
  • How to simplify twice-yearly Medicaid redeterminations and work and community engagement requirements

HCBS

  • Direct care workforce
  • Waivers - expansion of slots and areas (TBI)
  • Oversight

State Medicaid funding

  • Plan to provide services with a budget shortfall
  • Staff shortages

Member experience

  • Access to services
  • Network adequacy
  • Care coordination
  • Communication/cultural responsiveness

Accountability and transparency

  • Spending
  • Fraud

Rural Health Grant

Chair Jenny Hobbs announced that Ada Elizabeth Gil Jimenez had resigned from the position of BAC Vice Chair, creating a vacancy that requires a new election.

Committee members nominated:

  • Janet McDaniel
  • Annette Smith
  • Matt Potter

All nominated members declined the nomination. Gwynneth Wildcatt self-nominated herself for the Vice Chair position. Following a vote by committee members, Gwynneth Wildcatt was elected as BAC Vice Chair.

The meeting was adjourned by Jenny Hobbs.

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