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View NCGA Bill Details2019-2020 Session
House Bill 488 (Public) Filed Wednesday, March 27, 2019
Intro. by Dobson, Bell, Presnell, Ball.

Status: Ref to the Com on Health, if favorable, Appropriations, Health and Human Services, if favorable, Appropriations, if favorable, Rules, Calendar, and Operations of the House (House action) (Mar 28 2019)
H 488

Bill Summaries:

  • Summary date: Mar 27 2019 - View Summary

    Includes whereas clauses. 

    Directs the Department of Health and Human Services, Division of Health Benefits (DHB), to adjust the per member per month (PMPM) capitation amount paid to local management entity/managed care organizations (LME/MCOs) operating capitated contracts for mental health, intellectual and other development disabilities, and substance abuse services to include amounts sufficient to increase wages paid to direct support personnel working in community-based Intermediate Care Facility Individuals with Intellectual Disabilities (ICF/IIDs) group homes for individuals with intellectual and developmental disabilities to align the wages paid to the direct support personnel with the current wages paid to State employees in State-owned developmental centers. Provides further parameters and requirements for the adjustments. Requires LME/MCOs to implement the adjustments by September 1, 2019, and provides for verification by providers that the funds are being used as required. Requires DHB to continue to work with stakeholders and service providers in order to develop appropriate methodology, track progress towards increasing direct support personnel wages, and determine additional resources necessary to achieve wage alignment with State employees in State-owned developmental centers.

    Appropriates $11.3 million in recurring funds from the General Fund to DHB each for the 2019-20 and 2020-21 fiscal years to implement the act. Requires DHB to maximize the ICF/IID assessment to increase the capitation payment rates for ICF/IIDs. Allows DHB to use all available proceeds of the adjusted ICF/IID assessment combined with appropriations under the act for purposes of implementation.

    Appropriates $250,000 in nonrecurring funds from the General Fund to DHB for the 2019-20 fiscal year to conduct an actuarial analysis and a wage and hour study of the NC Innovations waiver program (program). Requires the study and actuarial analysis to aid in determining the appropriate adjustments necessary to align wages paid to direct support personnel providing services under the program with wages paid to State employees in State-owned developmental centers. Requires the study and analysis to be completed no later than January 15, 2020, and requires DHB to provide a copy to the specified NCGA committee and division no later than that same date. After completion of the study and analysis, requires DHB to draft a plan providing for multiyear adjustments to provide for the described wage alignment, with verification from providers as described. Details ten required components of the analysis and plan. Requires DHB to submit a copy of the plan and related recommendations to the specified NCGA committee by March 1, 2020. Prohibits DHB from pursuing any State Plan amendments or any changes to the NC Innovations waiver that would be necessary to increase wages of direct support personnel providing services through the Innovations waiver to a minimum of $15 per hour, or the current wage paid to the described State employees, without further legislation directing the implementation of the wage increase.

    Directs DHB to use information from the Office of State Human Resources to establish a baseline methodology for determining the appropriate wages to be paid in implementing the act. Provides for adjustments DHB must make, including health insurance, retirement benefits, and other key factors that drive total labor costs, and allows further consideration of market-based wage comparisons, as provided. Further allows DHB to accept actuarially sound projections of competitive wage and hour data and other cost data from non-State entities in order to calculate wage analysis formulas and finalize exact rates. 

    Effective July 1, 2019.