Bill Summary – FastDemocracy

H.B. 580
                         GENERAL ASSEMBLY OF NORTH CAROLINA
                                                                                            Apr 5, 2023
                                     SESSION 2023                                     HOUSE PRINCIPAL CLERK
     H                                                                                              D
                                  HOUSE BILL DRH10260-MRa-22
     Short Title:   Expand Day/Employment Options/IDD.                                         (Public)
     Sponsors:      Representative Crawford.
     Referred to:
                                    A BILL TO BE ENTITLED
 AN ACT TO EXPAND MEANINGFUL DAY AND EMPLOYMENT SERVICES OPTIONS
     FOR MEDICAID BENEFICIARIES WITH INTELLECTUAL DISABILITIES.
 The General Assembly of North Carolina enacts:
             SECTION 1.(a) The Department of Health and Human Services, Division of Health
 Benefits (DHB), shall develop a new community-based Medicaid "in-lieu-of" service entitled
 "Community Activities and Employment Transitions" (CAET) that provides individualized
 services and supports for adults age 18 or older with intellectual disabilities. This CAET service
 shall be covered only under both (i) the BH IDD tailored plans and (ii) the combined 1915(b)
 and (c) waivers or an approved 1915(i) waiver. This new "in-lieu-of" service shall meet all of the
 following criteria:
             (1)     The new service shall be modeled after the nonresidential components of the
                     service entitled "Long-Term Community Supports" currently provided by
                     Vaya Health and similar services provided by Alliance Behavioral Healthcare.
             (2)     The CAET service shall not include any residential component.
             (3)     Services must originate from facilities that meet the home- and
                     community-based services standards established by DHB and under federal
                     law.
             SECTION 1.(b) In the development of the new CAET service in accordance with
 subsection (a) of this section, DHB shall collaborate with the Marketing Association for
 Rehabilitation Centers (MARC), the North Carolina Association for Rehabilitation Facilities
 (NCARF), the North Carolina Association of Professional Supported Employment (NCAPSE),
 all LME/MCOs, and other appropriate stakeholders. Concurrent with the development of the new
 CAET service, DHB also shall collaborate with those stakeholders to review any relevant rules,
 including 10A NCAC 27G .2301 through .2306. DHB shall amend any relevant rules and, if
 necessary, may adopt additional rules to account for the numerous community-based activities
 and employment services that may be provided to Medicaid beneficiaries as part of this new
 "in-lieu-of" service.
             SECTION 1.(c) Consistent with the authority granted under G.S. 108A-54(e), DHB
 may submit any State Plan amendments or waivers, or request other approval from the Centers
 for Medicare and Medicaid Services, necessary for the implementation of the new CAET service
 developed under subsection (a) of this section. Coverage of the new service may not begin earlier
 than January 1, 2024.
             SECTION 2. No later than December 1, 2023, DHB shall submit a report to the Joint
 Legislative Oversight Committee on Medicaid and NC Health Choice detailing the following
                                  *DRH10260-MRa-22*
     General Assembly Of North Carolina                                                  Session 2023
 information related to the development of the new CAET service in accordance with Section 1
 of this act:
              (1)    The definition developed for the CAET service and any new Medicaid clinical
                     coverage policy or changes to an existing Medicaid clinical coverage policy.
              (2)    The anticipated annual cost to the State of adding the proposed new service.
              (3)    Any legislative changes necessary for the implementation of the CAET
                     service.
              (4)    Any recommendations regarding the future establishment of a new facility
                     license for facilities providing the CAET service.
              (5)    Whether DHB is able to add this coverage pursuant to its authority under
                     G.S. 108A-54(e) or whether appropriations in addition to those in Section 3
                     of this act are required prior to implementation. If DHB intends to add this
                     coverage pursuant to its authority under G.S. 108A-54(e), the expected
                     implementation date.
              SECTION 3. There is appropriated from the General Fund to the Department of
 Health and Human Services, Division of Health Benefits (DHB), the sum of four million five
 hundred thousand dollars ($4,500,000) in recurring funds for the 2023-2024 fiscal year and the
 sum of nine million dollars ($9,000,000) in recurring funds for the 2024-2025 fiscal year to be
 used for the implementation of the CAET service developed in accordance with Section 1 of this
 act. These funds shall provide a State match for eight million seven hundred thousand dollars
 ($8,700,000) in recurring federal funds for the 2023-2024 fiscal year and the sum of seventeen
 million four hundred thousand dollars ($17,400,000) in recurring federal funds for the 2024-2025
 fiscal year, and those federal funds are appropriated to DHB to pay for costs associated with the
 implementation of the CAET service developed in accordance with Section 1 of this act.
              SECTION 4. Section 3 of this act is effective July 1, 2023. The remainder of this act
 is effective when it becomes law.
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