GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2011
H 2
HOUSE BILL 1075*
Committee Substitute Favorable 6/5/12
Short Title: LME/MCO Governance. |
(Public) |
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Sponsors: |
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Referred to: |
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May 24, 2012
A BILL TO BE ENTITLED
AN ACT to make changes in governance of Local management entities with respect to the implementation of statewide expansion of the 1915(b)/(c) medicaid waiver, as recommended by The Joint Legislative Oversight Committee on Health and Human Services.
The General Assembly of North Carolina enacts:
SECTION 1. G.S. 122C-115(a) reads as rewritten:
"§ 122C-115. Duties of counties; appropriation and allocation of funds by counties and cities.
(a) A county shall provide mental health, developmental disabilities, and substance abuse services in accordance with rules, policies, and guidelines adopted pursuant to statewide restructuring of the management responsibilities for the delivery of services for individuals with mental illness, intellectual or other developmental disabilities, and substance abuse disorders under a 1915(b)/(c) Medicaid Waiver through an area authority or through a county program established pursuant to G.S. 122C-115.1. Beginning July 1, 2012, the catchment area of an area authority or a county program shall contain a minimum population of at least 300,000. Beginning July 1, 2013, the catchment area of an area authority or a county program shall contain a minimum population of at least 500,000. To the extent this section conflicts with G.S. 153A-77(a), the provisions of G.S. 153A-77(a) control."
SECTION 2.(a) G.S. 122C-116 reads as rewritten:
"§ 122C-116. Status of area authority; status of consolidated human services agency.
(a) An area
authority is a local political subdivision of the State except that a single
county area authority is considered a department of the county in which it is
located for the purposes of Chapter 159 of the General Statutes.State.
(b) A consolidated human services agency is a department of the county."
SECTION 2.(b) G.S. 122C-115.1(i) reads as rewritten:
"(i) Except as
otherwise specifically provided, this Chapter applies to counties that provide
mental health, developmental disabilities, and substance abuse services through
a county program. As used in the applicable sections of this Article, the terms
"area authority", "area program", and "area
facility" shall be construed to include "county program". The
following sections of this Article do not apply to county programs:
(1) G.S. 122C-115.3,
122C-116, 122C-117, and 122C-118.1.
(2) G.S. 122C-119
and G.S. 122C-119.1.
(3) G.S. 122C-120
and G.S. 122C-121.
(4) G.S. 122C-127.
(5) G.S. 122C-147.
(6) G.S. 122C-152
and G.S. 122C-153.
(7) G.S. 122C-156.
(8) G.S. 122C-158."
SECTION 3.(a) G.S. 122C-118.1 reads as rewritten:
"§ 122C-118.1. Structure of area board.
(a) An area
board shall have no fewer than 11 and no more than 25 members. However, the
area board for a multicounty area authority consisting of eight or more counties
may have up to 30 members. In a single-county area authority, the members shall
be appointed by the board of county commissioners. Except as otherwise
provided, in areas consisting of more than one county, each board of county
commissioners within the area shall appoint one commissioner as a member of the
area board. These members shall appoint the other members. The boards of county
commissioners within the multicounty area shall have the option to appoint the
members of the area board in a manner other than as required under this section
by adopting a resolution to that effect. The boards of county commissioners in
a multicounty area authority shall indicate in the business plan each board's
method of appointment of the area board members in accordance with
G.S. 122C-115.2(b). These appointments shall take into account sufficient
citizen participation, representation of the disability groups, and equitable
representation of participating counties. Individuals appointed to the board
shall include two individuals with financial expertise, an individual with
expertise in management or business, and an individual representing the
interests of children. A member of the board may be removed with or without
cause by the initial appointing authority. Vacancies on the board shall be
filled by the initial appointing authority before the end of the term of the
vacated seat or within 90 days of the vacancy, whichever occurs first, and the
appointments shall be for the remainder of the unexpired term. An area
board shall have no fewer than 11 and no more than 21 voting members. The board
of county commissioners, or the boards of county commissioners within the area,
shall appoint members consistent with the requirements provided in subsection
(b) of this section. The process for appointing members shall ensure
participation from each of the constituent counties of a multicounty area
authority. If the board or boards fail to comply with the requirements of
subsection (b) of this section, the Secretary shall appoint the unrepresented
category. A member of the board may be removed with or without cause by the
initial appointing authority. The area board may declare vacant the office of
an appointed member who does not attend three consecutive scheduled meetings
without justifiable excuse. The chairman of the area board shall notify the
appropriate appointing authority of any vacancy. Vacancies on the board shall
be filled by the initial appointing authority before the end of the term of the
vacated seat or within 90 days of the vacancy, whichever occurs first, and the
appointments shall be for the remainder of the unexpired term.
(b) Except as
otherwiseWithin the maximum membership provided in this
subsection, not more than fifty percent (50%) ofsubsection (a) of
this section, the membersmembership of the area board shall
reside within the catchment area and represent the following: be
composed as follows:
(1) A physician
licensed under Chapter 90 of the General Statutes to practice medicine in North
Carolina who, when possible, is certified as having completed a residency in
psychiatry.At least one member who is a current county commissioner.
(2) A clinical
professional from the fields of mental health, developmental disabilities, or
substance abuse.The chair of the local Consumer and Family Advisory
Committee (CFAC) or the chair's designee.
(3) At least one
family member or individual from a citizens' organization composed primarily
of consumers or their family members,of the local CFAC, as recommended
by the local CFAC, representing the interests of individuals:the
following:
a. WithIndividuals
with mental illness;illness, or
b. InIndividuals
in recovery from addiction; oraddiction, or
c. With Individuals
with intellectual or other developmental disabilities.
(4) At least one openly declared consumer member of the local CFAC, as recommended by the local CFAC, representing the interests of the following:
a. WithIndividuals
with mental illness;illness, or
b. WithIndividuals
with intellectual or other developmental disabilities; ordisabilities,
or
c. In Individuals
in recovery from addiction.
(5) An individual with health care expertise and experience in the fields of mental health, intellectual or other developmental disabilities, or substance abuse services.
(6) An individual with health care administration expertise consistent with the scale and nature of the managed care organization.
(7) An individual with financial expertise consistent with the scale and nature of the managed care organization.
(8) An individual with insurance expertise consistent with the scale and nature of the managed care organization.
(9) An individual with social services expertise and experience in the fields of mental health, intellectual or other developmental disabilities, or substance abuse services.
(10) An attorney with health care expertise.
(11) A member who represents the general public and who is not employed by or affiliated with the Department of Health and Human Services, as appointed by the Secretary.
(12) The President of the LME/MCO Provider Council or the President's designee to serve as a nonvoting member who shall participate only in Board activities that are open to the public.
AnExcept as provided in subdivision (12) of this
subsection, an individual that contracts with a local management entity
(LME) for the delivery of mental health, developmental disabilities, and substance
abuse services may not serve on the board of the LME for the period during
which the contract for services is in effect. No person registered as a
lobbyist under Chapter 120C of the General Statutes shall be appointed to or
serve on an area authority board. Of the members described in subdivisions (2)
through (4) of this subsection, the boards of county commissioners shall ensure
there is at least one member representing the interest of each of the
following: (i) individuals with mental illness, (ii) individuals with
intellectual or other developmental disabilities, and (iii) individuals in
recovery from addiction.
(c) The board of county commissioners may elect to appoint a member of the area authority board to fill concurrently no more than two categories of membership if the member has the qualifications or attributes of the two categories of membership.
(d) Any member of
an area board who is a county commissioner serves on the board in an ex officio
capacity at the pleasure of the initial appointing authority, for a term not to
exceed the earlier of three years or the member's service as a county
commissioner. Any member of an area board who is a county manager serves on the
board at the pleasure of the initial appointing authority, for a term not to
exceed the earlier of three years or the duration of the member's
employment as a county manager. The terms of the othermembers on the
area board shall be for three years, except that upon the initial formation of
an area board in compliance with subsection (a) of this section,
one-third shall be appointed for one year, one-third for two years, and all
remaining members for three years. Members, other than county commissioners
and county managers, Members shall not be appointed for more than twothree
consecutive terms. Board members serving as of July 1, 2006, may remain on
the board for one additional term. This subsection applies to all area
authority board members regardless of the procedure used to appoint members
under subsection (a) of this section.
(e) Upon request, the board shall provide information pertaining to the membership of the board that is a public record under Chapter 132 of the General Statutes."
SECTION 3.(b) All area boards shall meet the requirements of G.S. 122C-118.1, as amended by subsection (a) of this section, no later than July 1, 2013.
SECTION 4.(a) G.S. 122C-119.1 reads as rewritten:
"§ 122C-119.1. Area Authority board members' training.
All members of the governing body for an area authority shall
receive initial orientation on board members' responsibilities and annual training
provided by the Department inwhich shall include fiscal
management, budget development, and fiscal accountability. A member's refusal
to be trained shall be grounds for removal from the board."
SECTION 4.(b) The North Carolina Department of Health and Human Services, in cooperation with the School of Government and the local management entities, shall develop a standardized core curriculum for the training described in subsection (a) of this section.
SECTION 5. G.S. 122C-170(b) reads as rewritten:
"Part 4A. Consumer and Family Advisory Committees.
"§ 122C-170. Local Consumer and Family Advisory Committees.
…
(b) Each of the
disability groups shall be equally represented on the CFAC, and the CFAC shall
reflect as closely as possible the racial and ethnic composition of the
catchment area. The terms of members shall be three years, and no member may
serve more than twothree consecutive terms. The CFAC shall be composed
exclusively of:
(1) Adult consumers of mental health, developmental disabilities, and substance abuse services.
(2) Family members of consumers of mental health, developmental disabilities, and substance abuse services.
…."
SECTION 6. Area authorities may add one or more additional counties to their existing catchment area by agreement of a majority of the existing member counties.
SECTION 7.(a) Beginning July 1, 2012, and for a period of two years thereafter, the Department of Health and Human Services shall not approve any county's request to withdraw from a multicounty area authority operating under the 1915(b)/(c) Medicaid Waiver. Not later than January 1, 2014, the Secretary shall adopt rules to establish a process for county disengagement that shall at a minimum ensure the following:
(1) Provisions of service are not disrupted by the disengagement.
(2) The disengaging county is either in compliance or plans to merge with an area authority that is in compliance with population requirements provided in G.S. 122C-155(a).
(3) The timing of the disengagement is accounted for and does not conflict with setting capitation rates.
(4) Adequate notice is provided to the affected counties, the Department of Health and Human Services, and the General Assembly.
(5) Provisions for distribution of any real property no longer within the catchment area of the area authority.
SECTION 7.(b) G.S. 122C-112.1 is amended by adding a new subdivision to read:
"(38) Adopt rules establishing a procedure for single-county disengagement from an area authority operating under a 1915(b)/(c) Medicaid Waiver."
SECTION 8. G.S. 122C-147(c) reads as rewritten:
"§ 122C-147. Financing and title of area authority property.
…
(c) All real
property purchased for use by the area authority shall be provided by local or
federal funds unless otherwise allowed under subsection (b) of this section or
by specific capital funds appropriated by the General Assembly. The title to
this real property and the authority to acquire it is held by the county
where the property is located. The authority to hold title to real property and
the authority to acquire it, including the area authority's authority to
finance its acquisition by an installment contract under G.S. 160A-20, may
be held by the area authority or by the contracting governmental entity with
the approval of the board or boards of commissioners of all the counties that comprise
the area authority. The approval of a board of county commissioners shall be by
resolution of the board and may have any necessary or proper conditions,
including provisions for distribution of the proceeds in the event of
disposition of the property by the area authority. area authority. Real
property may not be acquired by means of an installment contract under
G.S. 160A-20 unless the Local Government Commission has approved the
acquisition. No deficiency judgment may be rendered against any unit of local
government in any action for breach of a contractual obligation authorized by
this subsection, and the taxing power of a unit of local government is not and
may not be pledged directly or indirectly to secure any moneys due under a
contract authorized by this subsection.
…."
SECTION 9.(a) G.S. 122C-117 reads as rewritten:
"§ 122C-117. Powers and duties of the area authority.
(a) The area authority shall do all of the following:
…
(7) Appoint an area
director in accordance with G.S. 122C-121(d). The appointment is
subject to the approval of the board of county commissioners except that one or
more boards of county commissioners may waive its authority to approve the
appointment. The appointment shall be based on a selection by a search
committee of the area authority board. The search committee shall include
consumer board members, a county manager, and one or more county commissioners.
The Secretary shall have the option to appoint one member to the search
committee.
…
(17) Have the authority to borrow money with the approval of the Local Government Commission.
…
(c) Within 30 days
of the end of each quarter of the fiscal year, the area director and finance
officer of the area authority shall provide the quarterly report of the area
authority to the county finance officer. The county finance officer shall
provide the quarterly report to the board of county commissioners at the next
regularly scheduled meeting of the board. The clerk of the board of
commissioners shall notify the area director and the county finance officer if
the quarterly report required by this subsection has not been submitted within
the required period of time. This information shall be presented in a format
prescribed by the county. At least twice a year, this information shall be
presented in person and shall be read into the minutes of the meeting at which
it is presented. In addition, the area director or finance officer of the area
authority shall provide to the board of county commissioners ad hoc reports
as requested by the board of county commissioners.delivered
to the county and, at the request of the board of county commissioners, may be
presented in person by the area director or the director's designee.
…."
SECTION 9.(b) G.S. 122C-115.2 is amended by adding a new subsection to read:
"(e) The Secretary may waive any requirements of this section that are inconsistent with or incompatible with contracts entered into between the Department and the area authority for the management responsibilities for the delivery of services for individuals with mental illness, intellectual or other developmental disabilities, and substance abuse disorders under a 1915(b)/(c) Medicaid Waiver."
SECTION 10. Part 2 of Article 4 of Chapter 122C of the General Statutes is amended by adding a new section to read:
"§ 122C-126.1. Confidentiality of competitive health care information.
(a) For the purposes of this section, competitive health care information means information relating to competitive health care activities by or on behalf of the area authority. Competitive health care information shall be confidential and not a public record under Chapter 132 of the General Statutes; provided that any contract entered into by or on behalf of an area authority shall be a public record, unless otherwise exempted by law, or the contract contains competitive health care information, the determination of which shall be as provided in subsection (b) of this section.
(b) If an area authority is requested to disclose any contract that the area authority believes in good faith contains or constitutes competitive health care information, the area authority may either redact the portions of the contract believed to constitute competitive health care information prior to disclosure or, if the entire contract constitutes competitive health care information, refuse disclosure of the contract. The person requesting disclosure of the contract may institute an action pursuant to G.S. 132-9 to compel disclosure of the contract or any redacted portion thereof. In any action brought under this subsection, the issue for decision by the court shall be whether the contract, or portions of the contract withheld, constitutes competitive health care information, and in making its determination, the court shall be guided by the procedures and standards applicable to protective orders requested under Rule 26(c)(7) of the Rules of Civil Procedure. Before rendering a decision, the court shall review the contract in camera and hear arguments from the parties. If the court finds that the contract constitutes or contains competitive health care information, the court may either deny disclosure or may make such other appropriate orders as are permitted under Rule 26(c) of the Rules of Civil Procedure.
(c) Nothing in this section shall be deemed to prevent the Attorney General, the State Auditor, or an elected public body, in closed session, which has responsibility for the area authority, from having access to this confidential information. The disclosure to any public entity does not affect the confidentiality of the information. Members of the public entity shall have a duty not to further disclose the confidential information."
SECTION 11.(a) G.S. 126-5(a) reads as rewritten:
"§ 126-5. Employees subject to Chapter; exemptions.
(a) The provisions of this Chapter shall apply to:
(1) All State employees not herein exempt, and
(2) All employees of the following local entities:
a. Area mental
health, developmental disabilities, and substance abuse authorities.authorities,
except as otherwise provided in Chapter 122C of the General Statutes.
b. Local social services departments.
c. County health departments and district health departments.
d. Local emergency management agencies that receive federal grant-in-aid funds.
An employee of a consolidated county human services agency created pursuant to G.S. 153A-77(b) is not considered an employee of an entity listed in this subdivision.
(3) County employees not included under subdivision (2) of this subsection as the several boards of county commissioners may from time to time determine."
SECTION 11.(b) G.S. 122C-154 reads as rewritten:
"§ 122C-154. Personnel.
Employees under the direct supervision of the area director are employees of the area authority. For the purpose of personnel administration, Chapter 126 of the General Statutes applies unless otherwise provided in this Article. Employees appointed by the county program director are employees of the county. In a multicounty program, employment of county program staff shall be as agreed upon in the interlocal agreement adopted pursuant to G.S. 122C-115.1. Notwithstanding G.S. 126-9(b), an employee of an area authority may be paid a salary that is in excess of the salary ranges established by the State Personnel Commission. Any salary that is higher than the maximum of the applicable salary range shall be supported by documentation of comparable salaries in comparable operations within the region and shall also include the specific amount the board proposes to pay the employee. The area board shall not authorize any salary adjustment that is above the normal allowable salary range without obtaining prior approval from the Secretary."
SECTION 11.(c) G.S. 122C-121(a1) reads as rewritten:
"(a1) The area board shall
establish the area director's salary under Article 3 of Chapter 126 of the
General Statutes. An area board may request an adjustment to the salary
ranges under G.S. 126-9(b). The request shall include specific information
supporting the need for the adjustment, including comparative salary and
patient caseload data for other LMEs, and shall also include the specific
amount the area board proposes to pay the director. The area board shall not
request a salary adjustment that is more than ten percent (10%) above the
normal allowable salary range as determined by the State Personnel Commission.Notwithstanding
G.S. 126-9(b), an area director may be paid a salary that is in excess of
the salary ranges established by the State Personnel Commission. Any salary
that is higher than the maximum of the applicable salary range shall be
supported by documentation of comparable salaries in comparable operations
within the region and shall also include the specific amount the board proposes
to pay the director. The area board shall not authorize any salary adjustment
that is above the normal allowable salary range without obtaining prior
approval from the Secretary."
SECTION 12.(a) G.S. 153A-76 reads as rewritten:
"§ 153A-76. Board of commissioners to organize county government.
The board of commissioners may create, change, abolish, and consolidate offices, positions, departments, boards, commissions, and agencies of the county government, may impose ex officio the duties of more than one office on a single officer, may change the composition and manner of selection of boards, commissions, and agencies, and may generally organize and reorganize the county government in order to promote orderly and efficient administration of county affairs, subject to the following limitations:
(1) The board may not abolish an office, position, department, board, commission, or agency established or required by law.
(2) The board may not combine offices or confer certain duties on the same officer when this action is specifically forbidden by law.
(3) The board may not discontinue or assign elsewhere a function or duty assigned by law to a particular office, position, department, board, commission, or agency.
(4) The board may
not change the composition or manner of selection of a local board of
education, the board of health, the board of social services,the board
of elections, or the board of alcoholic beverage control.
(5) A board may not consolidate an area mental health, developmental disabilities, and substance abuse services board into a consolidated human services board. The board may not abolish an area mental health, developmental disabilities, and substance abuse board, except as provided in Chapter 122C of the General Statutes. This subdivision shall not apply to any board that has exercised the powers and duties of an area mental health, developmental disabilities, and substance abuse services board as of January 1, 2012."
SECTION 12.(b) G.S. 153A-77 reads as rewritten:
"§ 153A-77. Authority of boards of commissioners in certain counties over commissions, boards, agencies, etc.
(a) In the exercise
of its jurisdiction over commissions, boards and agencies, the board of county
commissioners may assume direct control of any activities theretofore conducted
by or through any commission, board or agency by the adoption of a resolution
assuming and conferring upon the board of county commissioners all powers,
responsibilities and duties of any such commission, board or agency. This subsectionsection
shall apply to the board of health, the social services board, area mental
health, developmental disabilities, and substance abuse area board andor
any other commission, board or agency appointed by the board of county
commissioners or acting under and pursuant to authority of the board of county
commissioners of said county except as provided in G.S. 153A-76. A
board of county commissioners exercising the power and authority under this
subsection may, notwithstanding G.S. 130A-25, enforce public health rules
adopted by the board through the imposition of civil penalties. If a public
health rule adopted by a board of county commissioners imposes a civil penalty,
the provisions of G.S. 130A-25 making its violation a misdemeanor shall
not be applicable to that public health rule unless the rule states that a
violation of the rule is a misdemeanor. The board of county commissioners may
exercise the power and authority herein conferred only after a public hearing
held by said board pursuant to 30 days' notice of said public hearing given in
a newspaper having general circulation in said county.
The board of county commissioners may also appoint advisory boards, committees, councils and agencies composed of qualified and interested county residents to study, interpret and develop community support and cooperation in activities conducted by or under the authority of the board of county commissioners of said county.
(b) In the exercise of its jurisdiction over commissions, boards, and agencies, the board of county commissioners of a county having a county manager pursuant to G.S. 153A-81 may:
(1) Consolidate the
provisioncertain provisions of human services in the county under
the direct control of a human services director appointed and supervised by the
county manager in accordance with subsection (e) of this section;
(2) Create a consolidated human services board having the powers conferred by subsection (c) of this section;
(3) Create a
consolidated county human services agency having the authority to carry out the
functions of any combination of commissions, boards, or agencies appointed
by the board of county commissioners or acting under and pursuant to authority
of the board of county commissioners, including the local health
department, the county department of social services, andor the
area mental health, developmental disabilities, and substance abuse services
authority; and
(4) Assign other county human services functions to be performed by the consolidated human services agency under the direction of the human services director, with policy-making authority granted to the consolidated human services board as determined by the board of county commissioners.
(c) A consolidated human services board appointed by the board of county commissioners shall serve as the policy-making, rule-making, and administrative board of the consolidated human services agency. The consolidated human services board shall be composed of no more than 25 members. The composition of the board shall reasonably reflect the population makeup of the county and shall include:
(1) Eight persons who are consumers of human services, public advocates, or family members of clients of the consolidated human services agency, including: one person with mental illness, one person with a developmental disability, one person in recovery from substance abuse, one family member of a person with mental illness, one family member of a person with a developmental disability, one family member of a person with a substance abuse problem, and two consumers of other human services.
(1a) Notwithstanding subdivision (1) of this subsection, a consolidated human services board not exercising powers and duties of an area mental health, developmental disabilities, and substance abuse services board shall include four persons who are consumers of human services.
(2) Eight persons who are professionals, each with qualifications in one of these categories: one psychologist, one pharmacist, one engineer, one dentist, one optometrist, one veterinarian, one social worker, and one registered nurse.
(3) Two physicians licensed to practice medicine in this State, one of whom shall be a psychiatrist.
(4) One member of the board of county commissioners.
(5) Other persons, including members of the general public representing various occupations.
The board of county commissioners may elect to appoint a member of the consolidated human services board to fill concurrently more than one category of membership if the member has the qualifications or attributes of more than one category of membership.
All members of the consolidated human services board shall be residents of the county. The members of the board shall serve four-year terms. No member may serve more than two consecutive four-year terms. The county commissioner member shall serve only as long as the member is a county commissioner.
The initial board shall be appointed by the board of county commissioners upon the recommendation of a nominating committee comprised of members of the preconsolidation board of health, social services board, and area mental health, developmental disabilities, and substance abuse services board. In order to establish a uniform staggered term structure for the board, a member may be appointed for less than a four-year term. After the subsequent establishment of the board, its board shall be appointed by the board of county commissioners from nominees presented by the human services board. Vacancies shall be filled for any unexpired portion of a term.
A chairperson shall be elected annually by the members of the consolidated human services board. A majority of the members shall constitute a quorum. A member may be removed from office by the county board of commissioners for (i) commission of a felony or other crime involving moral turpitude; (ii) violation of a State law governing conflict of interest; (iii) violation of a written policy adopted by the county board of commissioners; (iv) habitual failure to attend meetings; (v) conduct that tends to bring the office into disrepute; or (vi) failure to maintain qualifications for appointment required under this subsection. A board member may be removed only after the member has been given written notice of the basis for removal and has had the opportunity to respond.
A member may receive a per diem in an amount established by the county board of commissioners. Reimbursement for subsistence and travel shall be in accordance with a policy set by the county board of commissioners. The board shall meet at least quarterly. The chairperson or three of the members may call a special meeting.
(d) The consolidated human services board shall have authority to:
(1) Set fees for departmental services based upon recommendations of the human services director. Fees set under this subdivision are subject to the same restrictions on amount and scope that would apply if the fees were set by a county board of health, a county board of social services, or a mental health, developmental disabilities, and substance abuse area authority.
(2) Assure compliance with laws related to State and federal programs.
(3) Recommend creation of local human services programs.
(4) Adopt local health regulations and participate in enforcement appeals of local regulations.
(5) Perform regulatory health functions required by State law.
(6) Act as coordinator or agent of the State to the extent required by State or federal law.
(7) Plan and recommend a consolidated human services budget.
(8) Conduct audits and reviews of human services programs, including quality assurance activities, as required by State and federal law or as may otherwise be necessary periodically.
(9) Advise local officials through the county manager.
(10) Perform public relations and advocacy functions.
(11) Protect the public health to the extent required by law.
(12) Perform comprehensive
mental health services planning.planning if the county is exercising
the powers and duties of an area mental health, developmental disabilities, and
substance abuse services board under the consolidated human services board.
(13) Develop dispute resolution procedures for human services contractors and clients and public advocates, subject to applicable State and federal dispute resolution procedures for human services programs, when applicable.
Except as otherwise provided, the consolidated human services board shall have the powers and duties conferred by law upon a board of health, a social services board, and an area mental health, developmental disabilities, and substance abuse services board.
Local employees who serve as staff of a consolidated county
human services agency are subject to county personnel policies and ordinances
only and are not subject to the provisions of the State Personnel Act.Act,
unless the county board of commissioners elects to subject the local employees
to the provisions of that Act. All consolidated county human services agencies
shall comply with all applicable federal laws, rules, and regulations requiring
the establishment of merit personnel systems.
(e) The human services director of a consolidated county human services agency shall be appointed and dismissed by the county manager with the advice and consent of the consolidated human services board. The human services director shall report directly to the county manager. The human services director shall:
(1) Appoint staff of the consolidated human services agency with the county manager's approval.
(2) Administer State human services programs.
(3) Administer human services programs of the local board of county commissioners.
(4) Act as secretary and staff to the consolidated human services board under the direction of the county manager.
(5) Plan the budget of the consolidated human services agency.
(6) Advise the board of county commissioners through the county manager.
(7) Perform regulatory functions of investigation and enforcement of State and local health regulations, as required by State law.
(8) Act as an agent of and liaison to the State, to the extent required by law.
Except as otherwise provided by law, the human services
director or the director's designee shall have the same powers and duties as a
social services director, a local health director, andor a
director of an area mental health, developmental disabilities, and substance
abuse services authority.
(f) This section applies to counties with a population in excess of 425,000."
SECTION 13.(a) G.S. 122C-122 is repealed.
SECTION 13.(b) G.S. 35A-1202(4) reads as rewritten:
"§ 35A-1202. Definitions.
When used in the Subchapter, unless a contrary intent is indicated or the context requires otherwise:
…
(4)
"Disinterested public agent" means:means
a. Thethe
director or assistant directors of a local human services agency, orcounty
department of social services.
b. An
adult officer, agent, or employee of a State human services agency. TheExcept
as provided in G.S. 35A-1213(f), the fact that a disinterested public
agent is employed by a State or local human services agency that provides
financial assistance, services, or treatment to a ward does not disqualify that
person from being appointed as guardian.
.…"
SECTION 13.(c) G.S. 35A-1213 reads as rewritten:
"§ 35A-1213. Qualifications of guardians.
(a) The clerk may appoint as guardian an adult individual, a corporation, or a disinterested public agent. The applicant may submit to the clerk the name or names of potential guardians, and the clerk may consider the recommendations of the next of kin or other persons.
(b) A nonresident of the State of North Carolina, to be appointed as general guardian, guardian of the person, or guardian of the estate of a North Carolina resident, must indicate in writing his willingness to submit to the jurisdiction of the North Carolina courts in matters relating to the guardianship and must appoint a resident agent to accept service of process for the guardian in all actions or proceedings with respect to the guardianship. Such appointment must be approved by and filed with the clerk, and any agent so appointed must notify the clerk of any change in the agent's address or legal residence. The clerk shall require a nonresident guardian of the estate or a nonresident general guardian to post a bond or other security for the faithful performance of the guardian's duties. The clerk may require a nonresident guardian of the person to post a bond or other security for the faithful performance of the guardian's duties.
(c) A corporation may be appointed as guardian only if it is authorized by its charter to serve as a guardian or in similar fiduciary capacities. A corporation shall meet the requirements outlined in Chapters 55 and 55D of the General Statutes. A corporation will provide a written copy of its charter to the clerk of superior court. A corporation contracting with a public agency to serve as guardian is required to attend guardianship training and provide verification of attendance to the contracting agency.
(d) A disinterested public agent who is appointed by the clerk to serve as guardian is authorized and required to do so; provided, if at the time of the appointment or any time subsequent thereto the disinterested public agent believes that his role or the role of his agency in relation to the ward is such that his service as guardian would constitute a conflict of interest, or if he knows of any other reason that his service as guardian may not be in the ward's best interest, he shall bring such matter to the attention of the clerk and seek the appointment of a different guardian. A disinterested public agent who is appointed as guardian shall serve in that capacity by virtue of his office or employment, which shall be identified in the clerk's order and in the letters of appointment. When the disinterested public agent's office or employment terminates, his successor in office or employment, or his immediate supervisor if there is no successor, shall succeed him as guardian without further proceedings unless the clerk orders otherwise.
(e) Notwithstanding any other provision of this section, an employee of a treatment facility, as defined in G.S. 35A-1101(16), may not serve as guardian for a ward who is an inpatient in or resident of the facility in which the employee works; provided, this subsection shall not apply to or affect the validity of any appointment of a guardian that occurred before October 1, 1987.
(f) An individual that contracts with a local management entity (LME) for the delivery of mental health, developmental disabilities, and substance abuse services may not serve as a guardian for a ward for whom the individual is providing such services."
SECTION 13.(d) G.S. 35A-1292(a) reads as rewritten:
"§ 35A-1292. Resignation.
(a) Any guardian
who wishes to resign may apply in writing to the clerk,shall file a
motion with the clerk setting forth the circumstances of the case. If a
general guardian or guardian of the estate, at the time of making the
application, also exhibits his final account for settlement, and if the clerk
is satisfied that the guardian has fully accounted, the clerk may accept the
resignation of the guardian and discharge him and appoint a successor guardian,
but theguardian. The guardian so discharged and his sureties are
still liable in relation to all matters connected with the guardianship before
the discharge.discharge and shall continue to ensure that the ward's
needs are met until the clerk officially appoints a successor. The guardian
shall attend the hearing to modify the guardianship, if physically able."
SECTION 13.(e) In order to achieve continuity of care and services, any successor guardian shall make diligent efforts to continue existing contracts entered into under the authority of G.S. 122C-122 where consistent with the best interest of the ward as required by Chapter 35A of the General Statutes.
SECTION 14.(a) Section 1(a)(3) of S.L. 2011-264 reads as rewritten:
"(3) Designate a single
entityan area authority for mental health, developmental disabilities,
and substance abuse services to assume responsibility for all aspects of
Waiver management. The following operational models are acceptable options
for Local Management Entity (LME) applicants:acceptable:
a. Merger model: A single larger LME is formed from the merger of two or more LMEs.
b. Interlocal agreement among LMEs: A single LME is identified as the leader for all Waiver operations, financial management, and accountability for performance measures."
SECTION 14.(b) Section 1(c) of S.L. 2011-264 reads as rewritten:
"SECTION 1.(c) The Department shall require LMEs that have not been approved by the Department to operate a 1915(b)/(c) Medicaid Waiver by January 1, 2013, to merge with or be aligned through an interlocal agreement with an LME that has been approved by the Department to operate a 1915(b)/(c) Medicaid Waiver. If any LME fails to comply with this requirement, or fails to meet performance requirements of an approved contract with the Department to operate a 1915(b)/(c) Medicaid Waiver, the Department shall assign responsibility for management of the 1915(b)/(c) Medicaid Waiver on behalf of the noncompliant LME to an LME that is successfully operating the Waiver and successfully meeting performance requirements of the contract with the Department. Those LMEs approved to operate the 1915(b)/(c) Medicaid Waiver under an interlocal agreement must have a single LME entity designated as responsible for all aspects of Waiver operations and solely responsible for meeting contract requirements."
SECTION 15. This act is effective when it becomes law.