Bill Summaries: H990 GROUP HOME STABILIZATION & TRANSITION/FUNDS.

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  • Summary date: Apr 26 2019 - More information

    Includes whereas clauses.

    Establishes the Group Home Stabilization and Transition Fund (Fund) in the Department of Health and Human Services (DHHS), to be used to stabilize the operations of licensed, community-based group homes receiving State funds, to provide incentives for the local management entities/managed care organizations (LME/MCOs) operating as prepaid health plans to use State funds to facilitate the transition of those group homes to more sustainable sources of permanent funding, and to improve wages and retention of staff providing direct support to the residents of those group homes. Transfers $26 million in nonrecurring funds for 2019-20 and $26 million in nonrecurring funds for 2020-21 from the General Fund to the Fund. 

    Appropriates from the Fund to DHHS $26 million in nonrecurring funds for 2019-20 and $26 million in nonrecurring funds for 2020-21 to be used for the five specified purposes including incentivizing LME/MCOs as operating prepaid health plans to develop and implement new "in-lieu-of" services, 1915(b)(3) services, or other Medicaid-funded services to support the residential needs of Medicaid recipients living in licensed, community-based group homes, and increasing the existing per member per month payments to LME/MCOs for 2019-20 to quickly enable and facilitate the transition to a more appropriate and sustainable service-funding model for licensed, community-based group homes by January 1, 2020. Requires DHHS to report to the specified NCGA committees on a more appropriate and sustainable service model for residents of licensed, community-based group homes, to be implemented by January 1, 2020. Requires that State funds used to support residents of licensed community-based group homes prior to implementation to be reinvested in both the new funding model and increased rates to support and equalize wages of direct support personnel serving the residents. 

    Requires DHHS, by January 1, 2020, to implement a policy directing LME/MCOs to (1) implement in-lieu-of services or other Medicaid-funded services for all eligible residents with intellectual or other developmental disabilities living in licensed, community-based group homes receiving State funds and (2) transition eligible residents to these services. Requires DHHS, in cooperation with stakeholders and LME/MCOs, to develop an actuarially sound, needs-based rate model and rate methodology for new in-lieu-of Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) services, or other Medicaid-funded services, that will be specific to the residential support services needed in group homes serving Medicaid recipients with intellectual or other developmental disabilities. Sets out additional requirements for the rate methodology and rate structure. Requires DHHS to develop a process where State funds used to support Medicaid recipients with intellectual or other developmental disabilities living in licensed, community-based group homes prior to the implementation of the new rate structure are used for the new in-lieu-of services or other Medicaid services. Prohibits displacing residents as a result of being found ineligible for Medicaid services after implementing the new services. 

    Requires DHHS, by January 1, 2020, to implement a policy where LME/MCOs are incentivized to: (1) implement 1915(b)(3) alternative services for all eligible Medicaid recipients with mental health needs residing in group homes that receive State funds and (2) transition eligible residents to these services.  Requires DHHS to develop new model service definitions specific to the residential support services needed by Medicaid recipients with mental health needs living in licensed, community-based group homes, and to develop an actuarially sound rate model and rate methodology for the new alternative services. Requires DHHS to develop a process where State funds used to support Medicaid recipients with mental health needs living in licensed, community-based group homes before implementation of the new rate structure are used to fund the new alternative. Prohibits displacing residents as a result of being found ineligible for Medicaid services after implementing the new services. 

    Effective July 1, 2019. 


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