LME/MCO GOVERNANCE

View NCGA Bill Details2011-2012 Session
House Bill 1075 (Public) Filed Tuesday, May 22, 2012
TO MAKE CHANGES IN GOVERNANCE OF LOCAL MANAGEMENT ENTITIES WITH RESPECT TO THE IMPLEMENTATION OF STATEWIDE EXPANSION OF THE 1915(B)/(C) MEDICAID WAIVER, AS RECOMMENDED BY THE JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON HEALTH AND HUMAN SERVICES.
Intro. by Dollar, Burr

Status: Re-ref Com On Mental Health & Youth Services (Senate Action) (Jun 26 2012)
H 1075

Bill Summaries:

  • Summary date: Jun 21 2012 - More information

    House committee substitute makes the following changes to 3rd edition.
    Amends GS 122C-118.1, which makes changes to the structure of an area board, to permit a board of county commissioners in a multicounty area with a catchment population of at least 1.25 million to appoint area board members in a different manner from the method set out in the statute, upon receiving approval. Deletes provisions that allowed establishment of behavioral health authorities. Adds a section, amending GS 108A-70.9A (concerning Medicaid recipients appeals process), to add a definition for Department and make additional clarifying changes.


  • Summary date: Jun 11 2012 - More information

    Senate committee substitute makes the following changes to 2nd edition.
    Adds new section enacting Part 2B, Behavioral Health Authority, in Article 4 of GS Chapter 122C to provide for the creation of behavioral health authorities. Authorizes the governing board of a local management entity (LME), which has been successfully operating as a managed care organization under a 1915(b)/(c) Medicaid Waiver for at least three years, to create a behavioral health authority, subject to approval by the Secretary of the Department of Health and Human Services, to manage resources for mental health, intellectual and other developmental disabilities, and substance abuse services. Requires the behavioral health authority to fulfill all listed purposes, including ongoing communication and coordination with other organized systems and maintaining a local presence. Specifies that the LME area board becomes the board of directors for the behavioral health authority, with terms and membership as detailed. Enumerates powers of the behavioral health authority, including the power to perform public relations and community advocacy functions and the power to acquire property.
    Details the liability provisions applicable to persons serving as directors, trustees, and officers of a behavioral health authority. Specifies that the Local Government Budget and Fiscal Control Act, except for Part 1 (budgets), Part 2 (capital reserve funds), and Part 3 (fiscal control) of Article 3, applies to behavioral health authorities. Requires a behavioral health authority to appoint a finance officer and lists the officer’s powers. Sets forth additional provisions related to a behavioral health authority’s budget and provides for annual audits. Authorizes an authority to issue revenue bonds, borrow money, and purchase property under specified instruments. Permits the authority to enter into a contract for less than $5 million without approval by the Local Government Commission, except as detailed.
    Requires a behavioral health authority to establish Local Consumer and Family Advisory Committees and adopt the state’s policy on clients’ rights. Provides that a behavioral health authority has the same duties and responsibilities for involuntary commitments as area authorities. Requires an authority to establish Medicaid grievance procedures and to comply with statutory provisions for consumer and provider appeals. States that an authority is not a disinterested public agent, may not serve as the guardian for an individual adjudicated incompetent, and may not contract with a third party to serve as guardian for an individual who receives or could receive behavioral healthcare managed by the authority. Provides for disclosure of competitive healthcare information, as defined, according to specified provisions. States that proposed Part 2B controls if inconsistent with other laws. Makes conforming changes to the definition of local management entity in GS 122C-3(21) and to GS 122C-115(a). Makes other conforming changes.
    Amends GS 122C-118.1(b) to add as a member of an area board an administrator from a hospital providing mental health, developmental disabilities, and substance abuse emergency services to serve as a nonvoting member and participate only in board activities that are open to the public.
    Deletes sections amending GS 153A-76 and GS 153A-77, which prohibited a county board of commissioners from consolidating an area mental health, developmental disabilities, and substance abuse board into a consolidated human services board, or from abolishing an area board.
    Amends GS 122C-154 and GS 122C-121 to prohibit salary adjustments above the normal allowable salaries for area authority employees and directors without prior approval from the Director of the Office of State Personnel.
    Makes technical changes to the bill title.


  • Summary date: Jun 5 2012 - More information

    House committee substitute makes the following changes to 1st edition.
    Amends GS 122C-118.1 (structure of area boards) to add that the process for appointing members to the board must ensure participation from each of the counties of a multi-county area authority. Also specifies that registered lobbyists will not serve on a board. Amends proposed subdivision (5) in GS 153A-76 (prohibiting consolidation of an area mental health, development disabilities, and substance abuse services board into a consolidated human services board) to add that the provision does not apply to any board that has exercised the powers and duties of an area mental health, developmental disabilities, and substance abuse services board as of January 1, 2012. Restores, in GS 153A-77 (board of commissioner authority over consolidated boards, agencies, and commissions) the limitation of statute to counties with populations over 425,000, which was deleted in the previous version. Makes technical changes and adds a section to make conforming changes to GS 122C-115.1(i). Adds a section, amending SL 2011-264 (statewide expansion of 1915(b)(c) waiver), to clarify that local management entities (LMEs) must manage the waiver, and makes other clarifying changes.


  • Summary date: May 23 2012 - More information

    Amends GS 122C-115(a) (concerning duties of counties) to clarify that a county must provide mental health, developmental disabilities, and substance abuse services through an area authority or county program in accordance with statute and with statewide reform of services delivery under a 1915(b)/(c) Medicaid Waiver. Amends GS 122C-116(a) to remove condition that a single county area authority is a department of the county in which the authority is located. Rewrites GS 122C-118.1 (structure of area authority boards) to provide that an area board must have between 11 and 21 voting members (rather than 11 to 25, and up to 30 in certain multicounty authorities) appointed by the board or boards of county commissioners. Modifies the qualifications for board members and requires members to live in the catchment area. Directs all area boards to meet the revised requirements by July 1, 2013. Makes clarifying changes to GS 122C-119.1, requiring annual training for board members, and directs the NC Department of Health and Human Services (DHHS), the UNC School of Government, and local management entities (LMEs) to develop the training course.
    Provides that no member on the Consumer and Family Advisory Committees may serve more than three (rather than two) consecutive terms under GS 122C-170(b). Authorizes area authorities to add one or more counties to their catchment area if a majority of the existing member counties agree.
    Prohibits DHHS from approving a county’s request to withdraw from a multicounty area authority operating under a 1915(b)/(c) Medicaid waiver, beginning July 1, 2012, and extending for two years. Requires a process for county disengagement, as detailed, by January 1, 2014. Makes a conforming change to GS 122C-112.1 (duties of Secretary).
    Amends GS 122C-147(c) (concerning area authority property) to provide that the area authority (rather than the county) has title to real property purchased for the authority’s use. Amends GS 122C-117 (powers and duties of area authority) to grant authorities the power to borrow money with approval of the Local Government Commission and removes approval requirement for the director appointment. Also modifies the delivery procedure for the authority’s quarterly report. Amends GS 122C-115.2, allowing the Secretary to waive any provisions of the LME business plan requirements that are inconsistent with contracts between DHHS and the area authority. Enacts new GS 122C-126.1 to provide that all competitive health information is confidential and not a public record, with the exception of contracts of area authorities. Sets out the procedure for area authorities to follow after a request for disclosure.
    Amends GS 122C-121(a1) to allow the area director a salary in excess of the salary ranges established by the State Personnel Commission. Makes conforming changes to GS 126-5(a) and GS 122C-154 (allowing area authority employees a higher salary).
    Amends GS 153A-76 to prohibit a board of county commissioners from consolidating an area board into a consolidated human services board or from abolishing an area board. Makes conforming changes to GS 153A-77 and removes the limitation to counties with populations over 425,000.
    Repeals GS 122C-122 (public guardians) and directs any successor guardian to try to continue existing contracts if in the best interest of the incompetent person. Amends GS 35A-1213 (qualifications of guardians for incompetent persons) to add that individuals contracting to provide services to LMEs may not serve as guardians for individuals receiving those services. Makes a clarifying change, and modifies the definition of disinterested public agent in GS 35A-1202. Makes clarifying changes to GS 35A-1292 (resignation of guardian).


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