The Latest Assisted Living News from the NC General Assembly!
The Latest Assisted Living News from the NC General Assembly!
Legislative Update
News from the NCGA
April 16, 2019
by Tony Adams, Adams and Associates Government Relations
The 2019 long session of the NC General Assembly went into session in mid-January and is expected to adjourn at some point in late July. The primary issue this session is to resolve the different budget proposals of the House and Senate and then between what the legislature agrees to and what Gov Roy Cooper has proposed. Since Republicans no longer have a veto-proof majority, if the Governor vetoes the legislative budget the two sides will definitely have to work out a compromise, which could prolong the length of the session.
There are a significant number of bills that have been filed that are of interest to NCALA and other advocates for the elderly, which are discussed below.

House Bill 539

One of the most important bills is House Bill 539, which would appropriate $19,872,000 for the years 2019-2021 to provide temporary financial assistance to facilities licensed to accept State-County Special Assistance payments. The amount of these payments is equal to $184.000 per month for each resident of the facility as of the first day of the month who is a recipient of State-County Special Assistance.

House Bill 410

Would require nursing homes and adult care homes to have emergency electrical services available for use during power outages. Each facility would be required to provide emergency electrical services sufficient to provide heat, air conditioning, lighting and other essential electrical services required by the rules of the Medical Care Commission. NCALA opposes the bill in its current edition.

Senate Bill 539

Would repeal North Carolina’s Certificate of Need (CON) laws.

Senate Bill 361

One section in this bill would also repeal North Carolina’s CON laws. The section on the repeal of CON will generate much discussion and significant opposition. The bill has many sections that do not affect the assisted living community, but several sections that do. One, in particular, states, if the annual inspection of an adult care home is conducted separately from the inspection, required every two years to determine compliance with physical plant and life-safety requirements, the Division of Health Service Regulation (DHSR) shall not cite, as part of the annual inspection, any violation of law that overlaps with an area addressed by the physical plant and life-safety inspection, unless failure to address the violation during the annual inspection would pose a risk to resident health or safety.

House Bill 698

Would direct DHSR to undertake a compliance review of the standards for obtaining assisted living program accreditation from the Accreditation Commission for Health Care. Subject to satisfactory results of that compliance review, the NC Department of Health and Human Services (NC DHHS) would be authorized to issue adult care home licenses by virtue of accreditation. Certain accredited facilities would be exempt from routine inspections and monitoring and the star rating program for assisted living facilities. NCALA, along with other stakeholders, has been involved in ongoing discussions about the contents of the bill.

Senate Bill 302

Would authorize adult care homes to use service plans completed as the result of a Medicaid personal care services assessment to fulfill the activities of daily living portion of the required service plans or care plans for adult care home residents.

House Bill 325

Would also authorize adult care homes to use service plans completed as the result of a Medicaid personal care services assessment to fulfill the activities of daily living portion of the required service plans or care plans for adult care home residents. This bill also states that an applicant for assisted living administrator certification shall be certified as an assisted living administrator if the applicant meets these qualifications: is at least 21 years old; provides a satisfactory criminal background check from the State Repository of Criminal Histories; has no substantial findings on the NC Health Care Personnel Registry; has a high school diploma, and successfully completed the equivalent of two years at an accredited college or university, or has a minimum of 60 months of supervisory experience, or has a combination of education and experience approved by DHHS; successfully completes a NC DHHS-approved administrator-in-training program of at least 120 hours of study in courses relating to assisted living residences; and successfully completes a written examination administered by NC DHHS. (Supervisory experience means having full-time, direct management responsibility, including hiring or firing, over the equivalent of at least two full-time employees with direct resident care responsibilities. Such supervisory experience shall have been in a licensed adult care home or nursing home within the seven years preceding the date of application.)

House Bill 729 and Senate Bill 537

Would examine and establish a new payment methodology for adult care homes providing care to North Carolina’s Medicaid beneficiaries to promote health as well as fair and reasonable compensation for the services rendered. It is the intent of the General Assembly to provide funding to adult care homes in a manner that recognizes the importance of a stable and reliable funding stream to ensure access, choice, and quality of care within adult care homes. To achieve these aims, NC DHHS would be directed to establish and convene a workgroup to evaluate reimbursement options under managed care for adult care homes that consider all funding streams and to develop a service definition under managed care to accomplish this intent. The workgroup will consist of adult care home representatives and other relevant stakeholders.

House Bill 753

Would appropriate funds to NC DHHS to increase the personal needs allowance for Medicaid recipients who live in institutions in order to partially correct for inflation and allow the state’s residents in nursing homes, assisted living, and other institutions to retain more of their own funds to purchase individual items. DHHS is directed to increase the personal needs allowance from $30 to $70 for individual Medicaid recipients and from $60 to $140 for Medicaid recipients when both spouses are institutionalized. [FYI, NCALA does not approve of the use of the terms ‘institution’ and ‘institutionalized’ as used here.]

House Bill 752

Would increase the personal needs allowance for recipients of State-County Special Assistance and allow residents of assisted living communities to retain more of their own funds to purchase personal items. The personal needs allowance under the State-County Special Assistance program would increase from $46 per month per recipient to $70 per month per recipient.

House Bill 811

Would direct NC DHHS to increase the personal needs allowance for recipients of State-County Special Assistance and appropriating funds to offset the cost of the increase. NC DHHS’s Division of Aging and Adult Services would be directed to increase the personal needs allowance under the State-County Special Assistance program from $46 per month per recipient to $70 per month per recipient.

House Bill 754

Would appropriate funds to NC DHHS, Division of Aging and Adult Services, to enhance protections for residents in long-term care by moving the state’s long-term care ombudsman program toward national standards. The appropriated funds would create 10 full-time equivalent ombudsman positions within the office of the State Long-term Care Ombudsman program.
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
919-467-2486
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