May 5, 2017
by Tony Adams, Adams and Associates Government Relations

After a week of long days and late nights, on April 27 the NC Legislature met its self-imposed crossover deadline on which bills that do not have a financial impact must be passed in one chamber and sent to the other in order to remain eligible for consideration for the duration of the legislative session. That week also marked the final day that a bill could be filed for the long session of 2017. The Senate’s filing deadline had already passed on April 4, and the House’s deadline passed on April 25.

Between the two chambers, 1594 bills have been filed since the long session began in late January. Of the 919 bills filed in the House, 332 have been sent to the Senate, and 118 of the 675 bills filed in the Senate have been sent to the House. Additionally, bills with a fiscal impact—including fees, appropriations, or finance—are not subject to crossover and may be considered in committee and voted on at any time before the end of the 2017 session. Bills with a fiscal impact, if not passed in this year’s session, are also eligible for consideration in the 2018 short session. As the end of the fiscal year approaches, the House and Senate now turn their attention to finalizing their budget proposals for the next fiscal year.

Below we will cover issues that we feel are important to our members, issues that are of concern, and other issues that are being closely monitored.

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 (IDR) 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 rating certificate program for adult care homes. H657 passed the House of Representatives with no opposition and has been sent to the Senate for consideration in that chamber. NCALA has worked diligently to help secure passage of this legislation.

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; 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 long-term 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. The primary changes being proposed impact the way county commissioners make nominations and appointments to the community advisory committees and strengthen the accountability of community advisory committee members as designated agents of the NC Long-Term Care Ombudsman Program. The bill was vetted by the DHHS Office of Government Affairs, the NC Association of County Commissioners, and the NC Attorney General’s Office. H248 passed the House of Representatives with no opposing votes and has now been referred to the Senate for consideration. NCALA, in partnership with the NC Association Long Term Care Facilities, is strongly in support of this bill.

House Bill 513 (Set State/County Special Assistance Rates) establishes the maximum monthly State/County Special Assistance rates for adult care home residents and residents of Alzheimer’s/dementia special care units. For each year of the fiscal biennium of 2017–2019, the maximum monthly rate for residents in adult care homes will be $1,347 per month per resident, and for the same two years the maximum monthly rate for residents in Alzheimer’s/dementia special care units will be $1,515 per month per resident. The bill has been referred to the House Health Committee, and if it passes out of that committee it will then be referred to the House Appropriations Committee. Since the bill has a financial component, it was not susceptible to crossover and can be voted on at any time before the end of the 2017 long session.

House Bill 593 (Increase Personal Care Services Rate) increases the rate paid for personal care services provided to Medicaid and NC Health Choice recipients. Beginning on January 1, 2018, the NC Department of Health and Human Services, Division of Medical Assistance, will increase to $4.25 the fifteen-minute rate for personal care services. The rate increase will affect only half of the 2017–18 fiscal year. To implement the rate increases detailed in the bill, $17,979,122 will be appropriated from the state’s General Fund to the DHHS Division of Medical Assistance, and $37,385,544 for FY2018–19. These funds will provide a state match for an estimated $37,529,126 in federal funds for FY2017–18 and $78,037,561 in federal funds for FY2018–19. This bill has also been referred to the House Health Committee and it also, if passed in that committee, must then be referred to the Appropriations Committee. Since H593 has fiscal components, it too was not susceptible to crossover and can be discussed and voted on any time during this year’s session.

NCALA is also advocating for permanently lifting the Special Care Unit moratorium (Session Law 2015-241, Section 12G.2). Beginning on July 31, 2013, the law ordered the moratorium on Department of Health and Human Services, Division of Health Services Regulation-issued SCU licenses. The moratorium is due to be lifted on June 30, 2017.

Issues of Concern to NCALA

House Bill 456 (Establish Mandatory Dementia Care Training) 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 minimum standards for training. Adult care homes would bear the entire cost of the required training. H456 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. NCALA opposed this bill because it would be overly burdensome and costly for adult care homes.

House Bill 544 and Senate Bill 556 (Healthy Families and Workplaces/Paid Sick Days) 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) regulates arbitration agreements between residents and certain long-term 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.

Senate Bill 324 and House Bill 640 (Repeal Certificate of Need Laws) would if enacted repeal the Certificate of Need program that regulates the placement of new healthcare facilities in the state. S324 has been assigned to the Rules Committee and H640 to Health, then Insurance, and then Judiciary I. No action has been taken on either bill at his date.

NCALA is also working in alliance with the NC Coalition on Aging to advocate for several other issues of importance to our elderly citizens.

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