GENERAL ASSEMBLY OF NORTH CAROLINA
1995 SESSION
CHAPTER 583
The General Assembly of North Carolina enacts:
Section 1. G.S. 120-186.1 reads as rewritten:
"§
120-186.1. Commission; Alzheimer's Subcommittee. Alzheimer's
Subcommittee, Long-Term Care Subcommittee, and other subcommittees.
The Commission cochairmen shall appoint an Alzheimer's
Subcommittee. The cochairmen shall appoint as members of the Subcommittee three
Commission members and at least four but no more than six non-Commission
members. The Commission shall prescribe the duties of the Alzheimer's
Subcommittee which may include conducting studies on the availability and
efficacy of currently existing geriatric or memory disorder services and programs,
advising the Commission on matters regarding Alzheimer's services and programs,
and recommending to the Commission solutions to related problems.
(a) The Commission cochairs shall appoint subcommittees as needed to assist with the completion of the work of the Commission. These subcommittees may include an Alzheimer's Subcommittee, a Long-Term Care Subcommittee, or other special subject subcommittees. The cochairs shall appoint as members of any subcommittee not more than four Commission members and at least four but no more than six non-Commission members.
(b) The Commission cochairs shall prescribe the duties of any subcommittee created. Duties of the Alzheimer's Subcommittee may include conducting studies on the availability and efficacy of currently existing geriatric or memory disorder services and programs, advising the Commission on matters regarding Alzheimer's services and programs, and recommending to the Commission solutions to related problems. Duties of the Long-Term Care Subcommittee may include developing a long-term care policy for the State that has at least the following elements:
(1) Promotes elder independence, choice, and dignity;
(2) Provides a seamless, uniform system of flexible and responsive services;
(3) Provides single-entry access;
(4) Includes a wide range of home and community-based services available to all elderly who need them but targeted primarily to the most frail, needy elderly;
(5) Provides care and services at the least expense in the least confusing manner and based on the desires of the elder population and their families;
(6) Expands Medicaid income eligibility to allow more services in the home and community;
(7) Creates a single agency and budget stream to administer services to the elderly; and
(8) Approaches long-term care within the context of the entire health care system."
Sec. 2. Part 14B of Article 3 of Chapter 143B of the General Statutes reads as rewritten:
"Part 14B. Long-Term Care.
"§ 143B-181.5.
Department to develop systems of longt Long-term care policy.
The Secretary of the Department of Human Resources shall
develop effective systems of long-term care with interested counties to the
extent that federal, State and local funds are available to support the
expanded programs and services. The North Carolina General
Assembly finds that the aging of the population and advanced medical technology
have resulted in a growing number of persons who require assistance. The
primary resource for long-term care provision continues to be the family and
friends. However, these traditional caregivers are increasingly employed
outside the home. There is growing demand for improvement and expansion
of home and community-based long-term care services to support and complement
the services provided by these informal caregivers.
The North Carolina General Assembly further finds that the public interest would best be served by a broad array of long-term care services that support persons who need such services in the home or in the community whenever practicable and that promote individual autonomy, dignity, and choice.
The North Carolina General Assembly finds that as other long-term care options become more available, the relative need for institutional care will stabilize or decline relative to the growing aging population. The General Assembly recognizes, however, that institutional care will continue to be a critical part of the State's long-term care options and that such services should promote individual dignity, autonomy, and a home-like environment.
"§
143B-181.6. Screening program for elderly. Purpose and intent.
The Secretary of Human Resources shall develop a
comprehensive screening program for elderly people in need of care, to be
administered at the local level, focused on providing elderly persons with the
least restrictive level of care that meets the medical and social needs of the
person. This program shall provide for expansion of the preadmission screening
of applicants and recipients in need of long-term care, setting priorities
according to immediate need. The process should be made more efficient in
identifying those people in need of care who could remain at home if provided
the precise program of in-home care each individual requires. Private paying
patients may take advantage of the screening services and services necessary to
remain in their homes by paying fees for these services, pursuant to G.S.
108A-10 or G.S. 130-17(e) as appropriate. The screening shall be carried out by
a team of at least two people, a social worker and a registered nurse familiar
with care of the elderly, each of whom must be experienced in evaluation and
provision of in-home services. The process shall include a visit to the home by
at least one member of the screening team. The team in consultation with a
physician licensed to practice medicine in North Carolina shall determine if
in-home care, whether health, social or both would enable the person to stay at
home or in the community. The team shall plan precisely what program of care
and support services are available through both public or private agencies.
Provision must be made for such care in conformity with established quality
assurance procedures for the care so rendered, together with periodic
reassessment. Nothing contained in the act shall require counties to
participate in the comprehensive screening program. It is the
North Carolina General Assembly's intent in the State's development and
implementation of long-term care policies that:
(1) Long-term care services administered by the Department of Human Resources and other State and local agencies shall include a balanced array of health, social, and supportive services that promote individual choice, dignity, and the highest practicable level of independence;
(2) Home and community-based services shall be developed, expanded, or maintained in order to meet the needs of consumers in the least confusing manner and based on the desires of the elderly and their families;
(3) All services shall be responsive and appropriate to individual need and shall be delivered through a seamless system that is flexible and responsive regardless of funding source;
(4) Services shall be available to all elderly who need them but targeted primarily to the most frail, needy elderly;
(5) State and local agencies shall maximize the use of limited resources by establishing a fee system for persons who have the ability to pay;
(6) Institutional care shall be provided in such a manner and in such an environment as to promote maintenance or enhancement of the quality of life of each resident and timely discharge to a less restrictive care setting when appropriate; and
(7) State health planning for institutional bed supply shall take into account increased availability of other home and community-based services options.
"§
143B-181.7. Development and implementation of rules.
The Department of Human Resources shall define by rule the
population to be screened, establish a uniform screening and assessment
schedule, and promulgate a uniform reporting form. Prior to action by the
Department, the Secretary shall convene an implementation committee composed of
local providers, representatives of State agencies and organizations with
experience and information about in-home services and long-term care to assist
in implementation and development of these rules.
"§
143B-181.8. Utilization of Medicaid funds.
The Secretary of the Department of Human Resources may
utilize Medicaid funds to the extent provided for by federal law and regulation
for home health and personal care and seek such waivers as may be necessary to
implement this act including Medicaid eligibility criteria supporting the provision
of in-home care.
"§
143B-181.9. Reporting
The Department shall report to the Legislative Research
Commission on the implementation of this act, including the eligibility
requirements, screening processes, and financial barriers to implementation. Such
report shall be made no later than January 1, 1982, but the Legislative
Research Commission may require interim progress reports from the Department."
Sec. 3. This act is effective upon ratification.
In the General Assembly read three times and ratified this the 20th day of June, 1996.
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Dennis A. Wicker
President of the Senate
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Harold J. Brubaker
Speaker of the House of Representatives