Final 2017-2019 NC Budget Released ...
Final 2017-2019 NC Budget Released ...
Legislative Update
News from the NCGA
June 23, 2017
by Tony Adams, Adams and Associates Government Relations
On June 22, the 2017–19 budget was ratified by the NC House and Senate and will now be sent to Governor Roy Cooper for him to either sign or veto. The appointed budget conference committee of Senate and House members has been working behind the scenes for weeks on coming to an agreement on the different versions of the budget originally passed by both chambers.

2017 Legislative Issues of Importance to NCALA
Items Contained Within the 2017–19 Budget

INCREASED ACCESS TO PUBLIC BENEFITS FOR OLDER DUAL ELIGIBLE SENIORS: Directs the Department of Health and Human Services, Division of Social Services (Division), to continue implementing an evidence-based pilot program to increase access to public benefits for seniors aged 65 and older who are dually enrolled in Medicare and Medicaid, to: (1) improve the health and independence of seniors, and (2) reduce healthcare costs. The Division shall continue to partner with a not-for-profit firm for the purposes of engaging in a data-driven campaign to help seniors aged 65 and older who are dually enrolled in Medicare and Medicaid meet their basic social needs. The not-for-profit firm shall have demonstrated experience in assisting with these types of services.
TEMPORARY FINANCIAL ASSISTANCE FOR FACILITIES LICENSED TO ACCEPT STATE-COUNTY SPECIAL ASSISTANCE: Authorizes $5 million in non-recurring funding in each year of the biennium to continue the provision of temporary assistance to facilities that serve State/County Special Assistance recipients. Counties and the state will each provide 50% of the funding. Facilities will receive $34 per month for each resident who receives Special Assistance.
STATE/COUNTY SPECIAL ASSISTANCE: Specifies that for each year of the 2017–2019 fiscal biennium, the maximum monthly rate for residents in adult care home facilities shall be $1,182 per month per resident and for residents in Alzheimer’s/Dementia special care units the maximum monthly rate shall be $1,515 per month per resident.
RECOMMENDATION TO APPOINT A SUBCOMMITTEE ON AGING: States that the co-chairs of the Joint Legislative Oversight Committee on Health and Human Services may consider appointing a subcommittee on aging to examine the state’s delivery of services for older adults in order to (1) determine their needs and (2) make recommendations on how to address those needs. If a subcommittee is appointed, it is encouraged to seek input from a variety of stakeholders and interest groups and it shall submit an interim report of its findings and recommendations, including any proposed legislation, to the Joint Legislative Oversight Committee on Health and Human Services on or before March 1, 2018, and shall submit a final report of its findings and recommendations, including any proposed legislation, on or before November 1, 2018.
MORATORIUM ON SPECIAL CARE UNIT LICENSES: Specifies that for the period beginning July 1, 2017, and ending June 30, 2019, the Department of Health and Human Services, Division of Health Service Regulation, shall not issue any licenses for special care units as defined in GS 131D-4.6 and 16 GS 131E-114, except in situations noted in the provision. The Department is to submit a report to the Joint Legislative Oversight Committee on Health and Human Services and the Fiscal Research Division by March 1, 2019.
INCREASE IN PERSONAL CARE SERVICES RATE: Directs that beginning January 1, 2018, the Department of Health and Human Services, Division of Medical Assistance, shall increase to $3.90 the rate paid per 15-minute billing unit for personal care services provided pursuant to Clinical Coverage Policy 3L and for in-home aide, respite care in-home aide, and personal care assistance services provided under the Community Alternatives Program for Children (CAP-C) waiver pursuant to Clinical Coverage Policy 3K-1. This equates to an hourly rate of $15.60.
RETROACTIVE PERSONAL CARE SERVICES PAYMENT: Directs the Department of Health and Human Services, Division of Medical Assistance, to amend Section 5.5, Retroactive Prior Approval for PCS, of Clinical Coverage Policy 3L, State Plan Personal Care Services (PCS), to extend the allowable retroactive period for prior approvals for personal care services from 10 days to 30 days upon the same conditions that are currently required for retroactive prior approval of personal care services.
CERTIFICATE OF NEED: The compromise budget does NOT repeal the Certificate of Need Laws program that regulates the placement of new healthcare facilities in the state.

Other Bills of Interest

HOUSE BILL 657 (IMPROVE ADULT CARE HOME REGULATION): Modifies the laws prohibiting issuance of adult care home licenses due to prior violations, and also exempts from Certificate of Need (CON) review new institutional health services involving the acquisition of an unlicensed adult care home that was previously licensed. The bill also establishes a process for adult care homes to request informal dispute resolution of certain adverse inspection findings by county departments of social services prior to imposition of a penalty or issuance of a star rating certificate based on the adverse inspection findings. Also included in the bill is an order to amend the rules pertaining to minimum training for personal care aides and elimination of the 12- to 24-month penalty on adult care home star ratings and directing the Department of Health and Human Services to study the effectiveness of the North Carolina star-rated certificate program for adult care homes. H657 passed both the House and Senate overwhelmingly.
HOUSE BILL 248 (SUPPORT FOR OLDER ADULTS AND DHHS STUDY): Recommends that the co-chairs of the Joint Legislative Oversight Committee on Health and Human Services consider establishment of a subcommittee on aging and to make changes to the adult care home and nursing home advisory committees to conform to the administration for community living rules and recent changes to the state longterm care ombudsman program and to direct DHHS to study the Hope Act and related federal regulations and to make recommendations to the Joint Legislative Oversight Committee on Health and Human Services. NCALA, in partnership with the NC Association of Long Term Care Facilities, is strongly supportive of the bill. H248 passed the House of Representatives with no opposing votes and has now been referred to the Senate, where it has passed the Health Committee but has been re-referred to the Senate Rules Committee.

Issues of Concern to NCALA

HOUSE BILL 456 (ESTABLISH MANDATORY DEMENTIA CARE TRAINING): This bill does not have any fiscal component to it and did not get voted on before the April 27 crossover deadline, thus effectively killing it for this session of the legislature. The bill would require adult care homes, nursing homes, and combination homes that provide special care for individuals with Alzheimer’s Disease or other dementias to provide dementia care training to all staff, including direct care staff, administrative staff, and non-direct care staff—including housekeepers, cooks, and maintenance staff—at the adult care home and establish mimimum standards for training. Adult care homes would be required to bear the entire cost of the required training. NCALA opposed this bill because it would be overly burdensome and costly for adult care homes.
HOUSE BILL Bill 544 and SENATE BILL 556 (HEALTHY FAMILIES AND WORKPLACES/PAID SICK DAYS): These companion bills would require that all workers, except volunteer workers, have earned paid sick days to “address their own health needs and the needs of their families.” S544 has been assigned to the Senate Rules Committee and H544 was assigned to the House Health Committee, then to Commerce and then to Appropriations. So far, no action has been taken on either bill, and the chances are that neither bill will receive a hearing or vote this session. NCALA would oppose the bills in their current state if either came up in committee.
HOUSE BILL 822 (REGULATE ARBITRATION AGREEMENTS/ LTC FACILITIES): This bill would regulate arbitration agreements between residents and certain longterm care facilities by prohibiting pre-dispute binding arbitration agreements and establishing standards for post-dispute binding arbitration agreements. H822 was referred to the House Rules Committee and has received no movement in the committee. Since the bill has no fiscal impact, it is effectively dead for this legislative session.
For more information about the North Carolina General Assembly, or to identify your legislators, please visit www.ncleg.net. For more information on these and other legislative issues, please contact NCALA.

ADAMS AND ASSOCIATES GOVERNMENT RELATIONS

1706 Rangecrest Road, Raleigh, NC 27612
(919) 841-0964    (919) 801-1837 Cell
ta@adamsgov-relations.com
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