MEDICAID AND BEHAVIORAL HEALTH MODIFICATIONS (NEW).

View NCGA Bill Details2017-2018 Session
House Bill 403 (Public) Filed Thursday, March 16, 2017
AN ACT TO MODIFY THE MEDICAID TRANSFORMATION LEGISLATION.
Intro. by Dollar, Lambeth, Dobson, White.

Status: Ch. SL 2018-48 (House Action) (Jun 22 2018)

SOG comments (2):

Change long and short titles

Senate committee substitute to the 2nd edition changed long and short titles.  Long title was AN ACT MODIFYING CERTAIN REQUIREMENTS PERTAINING TO LOCAL MANAGEMENT ENTITIES/MANAGED CARE ORGANIZATIONS. Short title was LME/MCO CLAIMS REPORTING/MENTAL HEALTH AMDTS.

Short and Long Title Changes

Conference report to the 4th edition makes changes to the short  and long titles. The original titles are as follows:

MEDICAID AND BEHAVIORAL HEALTH MODIFICATIONS.

AN ACT TO MODIFY CERTAIN REQUIREMENTS PERTAINING TO LOCAL MANAGEMENT ENTITIES/MANAGED CARE ORGANIZATIONS, TO MODIFY THE MEDICAID TRANSFORMATION LEGISLATION, TO REQUIRE THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO NOTIFY THE GENERAL ASSEMBLY UPON THE SUBMISSION OR NON‑SUBMISSION OF A MEDICAID STATE PLAN AMENDMENT, AND TO MAKE CHANGES TO THE NORTH CAROLINA LME/MCO ENROLLEE GRIEVANCES AND APPEALS STATUTES TO CONFORM WITH RECENT CHANGES TO FEDERAL LAW.

Bill History:

H 403/S.L. 2018-48

Bill Summaries:

  • Summary date: Jun 25 2018 - More information

    AN ACT TO MODIFY THE MEDICAID TRANSFORMATION LEGISLATION. Enacted June 22, 2018. Effective June 22, 2018.


  • Summary date: Jun 15 2018 - More information

    Conference report deletes all provisions of 4th edition and replaces it with AN ACT TO MODIFY THE MEDICAID TRANSFORMATION LEGISLATION

    Amends SL 2015-245, Section 4, as amended by SL 2016-121, Section 2(b), SL 2017-57, Section 11H.17(a), and SL 2017-186, Section 4, modifying the definition of Prepaid Health Plan to also include a local management entity/managed care organization (LME/MCO) that operates or will operate a BH IDD Tailored Plan.

    Requires that Medicaid services currently covered by an LME/MCO will not be covered under any capitated Physicians Health Plan (PHP) contract other than a BH IDD Tailored Plan, except that all capitated PHP contracts must cover the set of specific services, including behavioral health services, crisis services and types of substance abuse treatment. Requires that capitated PHP contracts cover all Medicaid and NC Health Choice program aid categories except for an expanded set of specific recipients, including prison inmates and those being served through the Community Alternatives Program. Also includes those with a serious mental illness, emotional disturbance, substance use disorder, intellectual/developmental disability, and those with traumatic brain injury, but provides that recipients in this category will be enrolled in a BH IDD Tailored Plan when such plans become operational. Provides these recipients with the option to voluntarily enroll with a PHP, if doing so would be the only way to gain access to behavioral health services and informed consent is provided. Sets out specific requirements for recipients who must belong to this category, including those with serious mental illness, serious emotional disturbance, traumatic brain injury, and children with complex needs, developmental delays, or involvement in the juvenile justice system. 

    Increases number of capitated PHP contracts between the Division of Health Benefits and PHPs to provide coverage to Medicaid and NC Health Choice recipients statewide to four contracts. Creates exception to limit on number of capitated PHP contracts for BH IDD Tailored Plans. 

    Requires LME/MCOs to cease managing Medicaid services for all Medicaid recipients other than those in subdivision (5) of this section beginning on the date that capitated contracts begin. Until BH IDD Tailored Plans become operational, LME/MCOs must continue to manage Medicaid services that are currently covered by them, and capitation payments will continue. 

    Forbids Department of Health and Human Services (DHHS) from implementing BH IDD Tailored Plans until August 31, 2018, or until authorized to do so by the General Assembly.

    Defines BH IDD Tailored Plans (BH IDD plans) as capitated PHP contracts that meet all requirements in this act for capitated PHP contracts except as provided. Defines Standard Benefit Plans as Capitated PHP contracts that are not BH IDD plans. Sets out terms for the implementation of BH IDD plans by DHHS as follows. If 1915(b)/(c) waivers are discontinued, the following components of those waivers must be included in the 115 waiver. Operators of BH IDD plans must provide services currently offered under 1915(b)/(c) waivers, must operate care coordination functions, and provide other functions as listed. Forbids entities other than an LME/MCO to operate a BH IDD plan for the first four years of implementation. Sets out standards for the operation of BH IDD plans and terms for their continuance after initial four-year period. 

    Requires DHHS to report by June 22, 2018, with a plan for the implementation of BH IDD plans. Authorizes DHHS to take actions to implement BH IDD plans by August 31, 2018, or when authorized by a subsequent act. 


  • Summary date: Jun 28 2017 - More information

    Senate committee substitute makes the following changes to the 3rd edition.

    Part I. LME/MCO Modifications

    Deletes the provisions directing three actions to occur on the date when Medicaid capitated contracts with Prepaid Health Plans (PHPs) begin.

    Makes organizational changes.

    Modifies and makes organizational changes to Section 7 (was, Section 8). Moves to 7(b) the provision establishing that the salary range for area directors, which was last updated by the State Human Resources Commission in 2010, is void. Adds that, beginning on the date the act becomes law and until the Office of State Human Resources and the State Human Resources Commission complete a revision and update of the job description and salary range of the area directors as required by Section 7, an LME/MCO area board cannot pay an area director a salary that exceeds by more than 30% the average salary of the area directors of the remaining LME/MCOs. Provides that for area directors who are under an employment contract with an LME/MCO area board at the time the act becomes law: (1) the salary limitation required in Section 7(c)(2) applies after the end of the current contract period or upon amendment of the contract and applies to extensions of those contracts and (2) any salary reduction required by Section 7(d) applies after the end of the current contract period or upon amendment of the contract and applies to contract extensions (previously, provided that Section 7(d) applies to contracts with area directors beginning on or after the date that the State Human Resources Commission revises the salary range for area directors as provided in Section 7(b)). Makes conforming change to now provide that the Office of State Human Resources can recommend adjustments to the salary range for area directors to the State Human Resources Commission after the date the State Human Resources Commission revises the salary range for area directors required by Section 7(b)(3) and until four years after the date Medicaid capitated contracts with Prepaid Health Plans begin in accordance with SL 2015-245, as amended (previously, until the LME/MCOs are dissolved pursuant to the directive in Section 1 of the act, which is deleted by this committee substitute).

    Part II. Medicaid Transformation Modifications

    Modifies the proposed changes to Section 4 of SL 2015-245, as amended.

    Amends the changes to the definition of prepaid health plan (PHP), maintaining existing language that requires a majority of a provider-led entity's governing body to have experience treating beneficiaries of the NC Medicaid program, as determined by the Secretary of the Department of Health and Human Services (DHHS).

    Deletes the proposed changes to subsubdivision (4)a., prohibiting capitated PHP contracts from covering Medicaid services currently covered by the LME/MCOs for Medicaid recipients with a serious mental illness, a serious emotional disturbance, a substance use disorder, an intellectual/development disability, or who have survived a traumatic brain injury for four years after the date capitated contracts begin (currently, not to cover behavioral health services for Medicaid recipients currently covered by LME/MCOs for four years after the date capitated contracts begin; the previous edition deleted the provision entirely). Eliminates the proposed deletion of subsubdivision (4)b, maintaining existing language prohibiting capitated PHP contracts from covering dental services.

    Eliminates the proposed changes to subdivision (6a), instead maintaining existing language directing PHPs to comply with GS Chapter 58, to the extent allowed by federal law.

    Deletes the proposed elimination of the provision stating that this requirement does not require PHPs to cover services not covered by the Medicaid program, and instead amends subdivision (9) to require LME/MCOs to continue to manage the Medicaid services that are currently covered by the LME/MCOs, for four year after the date capitated PHP contracts begin, for Medicaid recipients with a serious mental illness, a serious emotional disturbance, a substance use disorder, an intellectual/developmental disability, or who have survived a traumatic brain injury. Directs that, beginning on the date that capitated contracts begin, LME/MCOs must cease managing Medicaid services for all other Medicaid recipients. Directs that the Division of Health Benefits continue to negotiate actuarially sound capitation rates directly with the LME/MCOs, but removes the provision requiring the negotiation to be in the same manner as currently utilized. Finally, Directs DHHS to report to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice no later than November 1, 2017, with a plan for defining and determining whether a Medicaid recipient has a serious mental illness, a serious emotional disturbance, a substance use disorder, an intellectual/developmental disability, or has survived a traumatic brain injury, and also a plan for ensuring that recipients who experience a change in status appropriately transition between the LME/MCO delivery system and the PHP delivery system. Directs DHHS to report to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice no later than March 1, 2018, with a plan for providing coordinated Medicaid services to the recipients described in subsubdivision (4)a.

    Deletes the proposed changes to subdivision (6) of Section 5 of SL 2015-245 as amended, maintaining existing language concerning the duty and responsibility of DHHS during Medicaid transformation to include entering into capitated PHP contracts for delivery of the Medicatid and NC Health Choice services described in Section 4, subdivision (a), of SL 2015-245. Deletes proposed new subdivision (7a), which required DHHS, within 30 days of this bill becoming law or upon CMS approval of a waiver if required, requiring providers enrolling or re-enrolling as a Medicaid or NC Health Choice provider to agree to accept 90% of the Medicaid fee-for-service rate for the services they provide to PHP enrollees if the provider has been offered a contract with a PHP but is not under a contract with that PHP, or if other conditions are met. Adds new subdivision (14), directing DHHS to study options for capitating Medicaid payments for dental services as part of the transformed Medicaid delivery system, including adding dental services coverage to capitated contracts or entering into capitated contracts with prepaid dental plans. Directs DHHS to report findings and recommendations on the options considered as well as any proposed legislation related to those findings and recommendations no later than March 1, 2018.


  • Summary date: Jun 15 2017 - More information

    Senate committee substitute makes the following changes to the 2nd edition.

    Amends the long and short titles.

    Provides that on the date when Medicaid capitated contracts with Prepaid Health Plans (PHPs) begin, all of the following shall occur: (1) PHPs shall manage all publicly funded behavioral health services currently managed by local management entities/managed care organizations (LME/MCOs) under contracts with the Department of Health and Human Services (DHHS), (2) LME/MCOs shall be dissolved, and (3) all remaining assets of LME/MCOs shall be transferred to DHHS to be used to satisfy the LME/MCO's liabilities and costs of PHP contracts. If there are insufficient funds, it is the Secretary's responsibility to satisfy LME/MCO liabilities.

    Makes amendments to GS 122C-112.1 effective January 1, 2018, and applicable to contracts entered into on or after that date.

    Deletes all amendments to the following laws: GS 122C-115.4(b) (regarding the primary functions of an LME); GS 122C-116 (Status of area authority; status of consolidated human services agency); GS 122C-118.1 (Structure of area board); GS 122C-124.2(c) (regarding the Secretary's responsibilities if the Secretary does not provide an LME/MCO with certification of compliance under that statute based upon the LME/MCO's failure to comply with certain requirements); GS 122C-121 (Area director); GS 122C-154 (Personnel); GS 126-11 (Local personnel system may be established; approval and monitoring; rules and regulations); and SL 2015-241, Section 12F.2(a) (directing DHHS to distribute at least one-twelfth of each LME/MCO's base budget at the beginning of the fiscal year).

    Deletes provisions applying the compensation limitations of GS 122C-121 to currently employed area directors, regardless of when they were hired, as well as provisions directing LME/MCOs to submit copies of current employment agreements to the Secretary and the Office of State Human Resources.

    Deletes proposed GS 122C-117(a2) (authorizing an area authority to subcontract certain managed care functions to other entities). Retains other amendments to that statute.

    Deletes proposed GS 122C-147.3 (LME/MCO use of funds).

    Amends GS 122C-124.1. Amends the caption to read Actions by the Secretary upon area authority or area director failure to comply or when area authority is not providing minimally adequate services. Deletes all references to county programs. Further directs the Secretary, upon the Secretary's determination that an area director has failed to comply with any requirement of State or federal law, rule, or regulation, or any requirement of the area authority's contract with the Department, or is doing any of the other currently listed things, to withhold funding for and assume control of the services as currently specified.

    Amends GS 122C-151 (Responsibilities of those receiving appropriations). Directs area authorities to not use resources for any of five listed expenses, including alcohol and first-class airfare. Authorizes the Secretary to delay, reduce, or deny payment upon an area authority's failure to complete actions necessary for the memorandum of agreement (was, for the development of a specified memorandum of agreement), or other listed actions.

    Applies the definitions of GS 122C-3 to the following section: Directs the Office of State Human Resources (OSHR), the Secretary of DHHS, and the LME/MCO area boards to revise and update the job description for area directors, as specified, by September 1, 2017. Directs OSHR to recommend to the State Human Resources Commission (Commission) a revision to the salary range for area directors, as specified, by December 1, 2017. Directs the Commission to revise the salary range for area directors based on the base of OSHR's recommendation by March 1, 2018. Makes the salary range for area directors, last updated in 2010, void. Prohibits LME/MCO area boards from authorizing any increase in the salaries of an area director until OSHR and the Commission complete a revision and update of the job description and salary range of area directors as directed. Does not prohibit an LME/MCO from authorizing a salary under GS 122C-121(a1) to be paid to an area director filling a vacant position after this act becomes law. Directs LME/MCO area boards to reestablish the salary for its area director upon completion of the revision and update by the OSHR and the Commission. Authorizes OSHR, after the date that the Commission revises the salary range for area directors, and until the LME/MCOs are dissolved under Section 1 of this act, to recommend adjustments to the salary range for area directors to the Commission. Provides requirements for forming such a recommendation.

    Amends SL 2015-245, as amended. Authorizes DHHS to adopt rules related to the activities listed in Section 4 of that session law (including the organization of the transformed Medicaid and NC Health Choice programs), and the regulation of PHPs, except that rules relating to PHP licensure under GS Chapter 58 or SL 2015-245, Section 6, are to be adopted by the Department of Insurance. Amends the definition ofprepaid health plan (PHP), requiring an entity not to be a provider-led entity to qualify as a commercial plan, and requiring a majority of a provider-led entity's governing body to have sufficient experience treating beneficiaries of the NC Medicaid program, as determined by the Secretary of DHHS (was, to have experience treating beneficiaries of the NC Medicaid program). Deletes the provision prohibiting capitated PHP contracts from covering behavioral health services for Medicaid recipients currently covered by LME/MCOs for four years after the date capitated contracts begin, and dental services, and prohibits capitated PHP contracts from covering the fabrication of eyeglasses. Provides that capitated PHP contracts do not cover recipients who are dually eligible for Medicaid and Medicare for two years after the date capitated contracts begin, recipients enrolled under the Medicaid Family Planning program, or recipients who are inmates of prisons. Deletes the provision directing the Division of Health Benefits to develop a long-term strategy to cover dual eligibles through capitated PHP contracts, and provides that enrollment of dually eligible recipients shall begin two years after the date capitated contracts begin, may be phased as described in a specified DHHS report, and shall be completed within two years after the date that dually eligible recipients are first enrolled with PHPs. Amends the number of required statewide capitated PHP contracts to be no less than three and no more than five. Amends the number of regional contracts to be up to 4 (was, up to 12). Directs PHPs to comply with 42 CFR 438 (was, GS Chapter 58, to the extent allowed by federal law and consistent with SL 2015-245), and deletes the provision stating that this requirement does not require PHP to cover services not covered by the Medicaid program. Deletes the provision instructing LMC/MCOs to continue to manage the behavioral health services currently covered for their enrollees for four years after the date capitated PHP contracts begin.

    Amends SL 2015-245, Section 5, as amended. Amends the description of DHHS's role and responsibility during Medicaid transformation, requiring DHHS to (1) submit to CMS modifications to the currently required submissions, including to the demonstration waiver applications. Requires DHHS to provide notice under GS 108A-54.1A if it submits any modifications; (2) define regions (was, define six regions), as specified, to ensure effective delivery of healthcare; (3) further develop standardized contract terms for capitated PHP contracts that require PHPs and hospitals to negotiate mutually acceptable rates, methods, and terms of payment, and require negotiated payments to hospitals to not exceed 125% of the fee-for-service Medicaid rate unless specifically approved by DHHS; and (4) within 30 days of this bill becoming law, or upon CMS's approval of a waiver when a waiver is required, requiring providers enrolling or re-enrolling as a Medicaid or NC Health Choice provider to agree to accept 90% of the Medicaid fee-for-service rate for the services they provide to PHP enrollees if the provider has been offered a contract with a PHP but is not under a contract with that PHP, or if other conditions are met.

    Amends GS 108A-54.1A (Amendments to Medicaid State Plan and Medicaid Waivers). Directs DHHS to notify the Joint Legislative Oversight Committee on Medicaid and NC Health Choice and the Fiscal Research Division of the submission of an amendment to the State Plan or a modification of a previously submitted amendment to the State Plan to the federal government, and of a determination that an amendment posted on its Web site will not be submitted to the federal government.

    Amends GS 108D-1 (Definitions), GS 108D-12(a), GS 108D-13, GS 108D-14, and GS 108D-15, replacing the termmanaged care actionwithadverse benefit determination.

    Further amends GS 108D-13 (LME/MCO level appeals). Requires a request for an LME/MCO level appeal of a notice of adverse benefit determination to be filed within 60 (was, 30) days of the mailing date of the adverse benefit determination. Directs the LME/MCO to resolve the appeal within 30 days (was, 45 days) of receiving the request for appeal. Requires, as an alternative to the requirement that an enrollee or network provider has exhausted the appeal procedures described in this statute or GS 108D-14, an enrollee to have been deemed to have exhausted the LME/MCO level appeals process under 42 CFR 438.408(c)(3), in order to file a request for a contested case hearing under GS 108D-15.

    Further amends GS 108D-14 (Expedited LME/MCO level appeals) to require an LME/MCO to resolve a granted expedited appeal no later than 72 hours (was, three working days) after receiving the request for an expedited appeal. Provides the same alternative requirement to request a contested case hearing as is provided in GS 108D-13.

    Further amends GS 108D-15 (Contested case hearings on disputed managed care actions). Requires a request for an appeal to be sent no later than 120 (was, 30) days after the mailing date of the notice of resolution.

    Makes the act effective when it becomes law, except as otherwise provided.


  • Summary date: Mar 29 2017 - More information

    House committee substitute makes the following changes to the 1st edition.

    Provides that the proposed amendments to GS 122C-112.1(a)(39) apply to contracts entered into on or after the effective date of the act.

    Amends the definition ofarea directorin GS 122C-3 to apply regulations of area directors to the administrative heads of area authorities, LMEs, or LME/MCOs, regardless of title or contract.

    Amends the proposed change to GS 122C-116 to correct a statutory reference.

    Makes a conforming change to the proposed amendment to GS 122C-117(a). Directs an area authority to maintain disability-specific infrastructure and competency to address the needs of disabilities covered by the 1915(b)/(c) Medicaid Waiver, to maintian administrative and clinical functions, and to maintain full accountability for all aspects of Medicaid Waiver operations and meeting contract requirements. Enacts new subsection (a2), authorizing an area authority to subcontract to other entities the following functions upon the written approval of the Secretary: information systems; customer service operations; claims processing; provider, enrollment, credentialing, and monitoring; professional services; treatment plan development; and referral to services. Provides that new subsection (a2) applies to area authority subcontracts to other entities entered into on or after the date the act becomes law.

    Clarifies that proposed GS 122C-121(a1)(2) refers to area boards. Further prohibits area boards from authorizing any salary adjustment for an area director that is above the normal allowable salary range, except as the requirements permit. Clarifies that the notification under proposed GS 122C-121(a3) must show how the Secretary determined that the salary did not comply. Provides that the total compensation for each area director must be reviewed for written approval by the Director of the Office of State Human Resources and the Secretary on an annual basis to determine compliance with this statute. Directs the area director to ensure compliance by the area authority with the powers and duties established under GS 122C-117 (instead of with the specified operational requirements of the area authority).

    Amends proposed GS 126-11(b2) to authorize the board of newly merged or consolidated area mental health authorities to petition the State Human Resources Commission to determine whether its personnel system meets the statutory requirements with the approval of three-quarters of the boards of commissioners of counties which comprise the newly merged or consolidated area mental health authority (currently, each county's board of commissioners).

    Provides in SL 2015-241 that for each month of the fiscal year after July, the DMH/DD/SAS shall distribute, on the first Tuesday of the month, one-eleventh of the amount of each LME/MCO's single stream allocation that remains after subtracting the amount of the distribution that was made to the LME/MCO in July of the fiscal year.


  • Summary date: Mar 16 2017 - More information

    Directs the Department of Health and Human Services (DHHS) to specify a standardized format for local management entities/managed care organizations (LME/MCOs) when submitting encounter data to DHHS. Directs LME/MCOs to submit specified data to DHHS using that format. Authorizes DHHS to use encounter data for five purposes, including measuring quality of services by LME/MCOs. Directs DHHS to work with LME/MCOs to ensure successful submission of encounter claims through NC Tracks. Directs DHHS to report to the Joint Legislative Oversight Committee on Health and Human Services by February 1, 2018, on the success of the data submission process.

    Amends GS 122C-112.1(a)(39) to direct the Secretary of DHHS (Secretary) to further develop standard contracts for LME/MCOs for management of State appropriations and federal block grant funds (in addition to contracts for the operation of the 1915(b)(C) Medicaid Waiver). Requires that the contracts include quality outcome measures for mental health, developmental disabilities, and substance use disorders. 

    Amends GS 122C-3 to delete the terms county program, and program director, to redefine area board and area director, and make conforming changes. Defines LME as an area authority (was, an area authority, county program, or consolidated human services agency).

    Amends GS 122C-115.4(b) to require an LME to obtain the prior written approval of the Secretary of the Department of Health and Human Services to enter into a contract with another entity to perform the primary functions of an LME. Applies to contracts entered into on or after the act's effective date.

    Amends GS 122C-116. Amends the caption to read "Status of area authority." Clarifies the definition of area authority to mean a local political subdivision established by counties for the management and delivery of services for individuals with mental illness, intellectual or other developmental disabilities, and substance use disorders under a 1915(b)/(c) Medicaid Waiver, and clarifies its status and functions as an LME. Clarifies the meaning of LME, and the terminology around it.

    Amends GS 122C-117(a) to clarify that GS Chapter 122C applies to the administrative head of the area authority, LME, or LME/MCO, regardless of title or contract.

    Amends GS 122C-118.1 to authorize boards of county commissioners to appoint an alternative area board appointment process subject to the Secretary's approval. Otherwise requires area board participation from each of the constituent counties of the area authority, and directs the Secretary to appoint members to the area board if the boards of county commissioners do not comply with the requirements of this statute. Requires a member of the board to have expertise in health insurance, health plan administration, or business expertise (currently this seat requires an individual with insurance expertise consistent with the scale and nature of the managed care organization). Requires that at least three-quarters of the constituent counties adopt a resolution to appoint area board members using an alternative process, in addition to obtaining approval from the Secretary, before the boards of county commissioners in a specified sized area can use the alternative appointment method. Sets additional requirements for seeking the Secretary's approval. No longer limits the power to remove members to the initial appointing authority. Requires LME/MCOs to annually notify the Secretary of 7 pieces of information, including the area board appointment process, beginning on July 1, 2017. Makes technical changes. Directs area boards not currently in compliance with the revised composition requirements to comply no later than October 1, 2017.

    Enacts new GS 122C-147.3 (LME/MCO use of funds). Directs LME/MCOS to use funds only for purposes related to their functions and responsibilities under GS Chapter 122C, or to carry out functions and responsibilities required by state law, federal law, or contract with DHHS.

    Amends GS 122C-124.2(c) to further direct the Secretary to take the described actions regarding notification of noncompliance when the Secretary determines that an LME/MCO has failed to comply with new GS 122C-147.3.

    Amends GS 122C-121 (Area director) to clarify that area directors are full-time employees who may not be employed in any other capacity for the performance of services while serving as area director. Provides new requirements for salaries higher than those established by the State Human Resources Commission, requiring the area board to submit a request for the higher salary to the Director of the Office of State Human Resources and the Secretary, and prior written approval from both the Director of the Office of State Human Resources and the Secretary. Sets limits on higher salaries based on the average range of other area directors. Prohibits the area board from authorizing a salary for an area director without complying with the above-described requirements. Directs the area board to reduce an area director's compensation that does not comply with the above-described requirements within 60 days of the Secretary's determination of noncompliance. Authorizes the Secretary to appoint a caretaker board of directors if noncompliance continues past 60 days. Subjects the total compensation to area directors to review and written approval by the Director of the Office of State Human Resources and the Secretary on at least an annual basis. Directs each area board to submit to the Secretary and the Director of the Office of State Human Resources a copy of all current employment agreements, contracts, and amendments, with its area director. Requires the area director to ensure compliance by the area authority with listed requirements, including disability infrastructure maintenance, customer service, and all aspects of Medicaid Waiver operations. Requires the appointment of the area director to be based on the recommendations of at least two candidates by a search committee. Requires 30 days' notice of termination of an area director. Applies both to currently employed area directors hired prior to the effective date of this act, and area directors hired after that date. Directs each LME/MCO to submit a copy of all current employment agreements, contracts, and amendments to the Secretary and the Director of the Office of State Human Resources within 30 days of this act's effective date.

    Amends GS 122C-141(d)(1) to allow counties that satisfy their duties under GS 122C-115(a) through a consolidated human services agency to be considered a qualified provider.

    Amends GS 122C-154 (Personnel) to delete the provision designating employees appointed by the county program director as county employees, and to make conforming changes. Amends provisions governing when an area authority's employees may be paid more than the established salary ranges.

    Amends GS 126-11 (Local personnel system may be established; approval and monitoring; rules and regulations) to provide that the merger or consolidation of two or more LME/MCOs requires a new petition to determine whether any portion of its total personnel system meets the requirements of the statute, and to make technical changes. 

    Amends SL 2015-241, Section 12F.2(a), to direct DHHS, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, to distribute 1/12 of each LME/MCO's single stream allocation on or before the last working day of each month, effective July 1, 2017.

    Repeals GS 122C-115.1 (County governance and operation of mental health, developmental disabilities, and substance abuse services programs), and GS Chapter 122C, Article 4, Part 2A (Consolidated human services).

    Directs the Revisor of Statutes to make conforming changes to GS Chapter 122C.

    Except as otherwise indicated, effective when the act becomes law.


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