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View NCGA Bill Details2017-2018 Session
Senate Bill 780 (Public) Filed Wednesday, May 30, 2018
Intro. by Tucker.

Status: Ref To Com On Rules and Operations of the Senate (Senate Action) (May 31 2018)

Bill History:

S 780

Bill Summaries:

  • Summary date: May 30 2018 - View Summary

    Section 1(a)

    Provides for the legislative intent concerning the importance of community housing resources for people with disabilities.

    Section 1(b)

    Directs the Department of Health and Human Services (DHHS) to develop 1915(b)(3) alternative services, in-lieu-of services, or services under any other authority as determined by DHHS to provide Medicaid coverage for services related to the treatment, rehabilitation, habilitation, supervision, and support of the Medicaid recipients living in a licensed supervised living facility as defined under 10A NCAC 27G .5601(c)(1) or (c)(3) (hereafter referred to as licensed facility) that need 24-hour services and supports as a result of the recipients' disabilities, as specified. Requires DHHS to create a separate service and service definition for each of the two classifications of Medicaid recipients specified.

    Section 1(c)

    Further requires DHHS to develop single-stream service definitions related to the treatment, rehabilitation, supervision, and support of the individuals who (1) are not eligible for Medicaid or (2) are not eligible for those services under Medicaid and who are individuals living in a licensed facility that need  24-hour services and supports as a result of the recipients' disabilities. Requires DHHS to create a separate service and service definition for each of the two classifications of eligible individuals. Requires the services to correspond to the services developed for the Medicaid recipients required by Section 1(b) of the act, and requires DHHS to ensure that the rates for the services are comparable to the Medicaid rates for those corresponding services. Requires the services required by Section 1(c) to begin no earlier than July 1, 2019.

    Section 1(d)

    Directs DHHS to consult with stakeholders, including local management entities/managed care organizations (LME/MCOs) and licensed facilities in developing service definitions for the services required above. Requires DHHS to ensure there are uniform service definitions to be implemented statewide. 

    Section 1(e)

    Directs DHHS to require, to the extent allowable by federal law, that LME/MCOs and any other entity responsible for the management of Medicaid funds relating to the provisions of behavioral health services for individuals with mental illness or intellectual or developmental disabilities: (1) contract with all licensed facilities which are either licensed on or before June 1, 2019, or which become licensed after June 1, 2019, and only developed upon written DHHS approval, in which Medicaid recipients with mental illness or with intellectual or developmental disabilities managed by the LME/MCO or other management entity reside; (2) authorize services related to the treatment, rehabilitation, habilitation, supervision, and support of the Medicaid recipients living in licensed facilities for all eligible Medicaid recipients who currently live in the facilities, meet the medical necessity criteria for those services, and are not enrolled in the Innovations Waiver; and (3) maintain current and accurate waiting list of individuals meeting the medical necessity criteria and requesting those services.

    Section 2

    Directs DHHS to submit, by October 1, 2018, to the Centers for Medicare and Medicaid Service (CMS) any State Plan amendments or any waivers necessary to establish coverage for the services related to the treatment and support of Medicaid recipients living in licensed facilities. Requires coverage to begin June 30, 2019, or upon CMS approval of any submitted amendments or waiver, whichever is later.

    Section 3

    Directs DHHS to submit a plan and schedule for the act's implementation no later than November 1, 2018, to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice. Requires the implementation plan and schedule to be developed in consultation with stakeholders, including those specified licensed facilities and LME/MCOs. Sets out eight required components of the implementation plan and schedule, including a description of the services to be offered and any new service definitions, procedures for maintaining a current and accurate recipient waiting list for services, procedures and time lines for notification of vacancies in supervising living facilities, and a method by which eligible recipients for new services developed are identified and timely referred to facilities when a vacancy occurs. 

    Section 4

    Directs DHHS to limit the licensing of new supervising living facilities after June 1, 2019, to only those developed with written approval by DHHS. Requires DHHS to adopt rules to implement this section no later than June 1, 2019.

    Section 5

    Amends SL 2017-57 (Appropriations Act of 2017) to appropriate to DHHS, Division of Medical Assistance up to $640,300 of the funds appropriated for the 2018-19 fiscal year for the 1915(c) waiver to be used for new 1915(b)(3) alternative services, in-lieu services, or other services for the treatment, rehabilitation, habilitation, supervision, and support of the Medicaid recipients living in licensed facilities.

    Section 6

    Directs DHHS and LME/MCOs to ensure that any state funding currently provided to licensed facilities that is supplanted by new funding resulting from the development of the services required by the act is reinvested in those facilities, with the reinvestment including the provision of services to residents of licensed facilities who are not eligible for the Medicaid services developed pursuant to Section 1(b) of the act.