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Overnight Respite Pilot at Adult Day Care Facilities Perceived as Favorable, but Lacked Objective Measures of Success (October 2014)

Summary

Session Law 2011-104 authorized the Department of Health and Human Services to pilot an overnight respite program in four facilities that provide adult day care and directed the Program Evaluation Division to evaluate its success. Stakeholders perceive the pilot as successful, but only one of the facilities consistently provided overnight respite. PED found the legislative mandate for the pilot and its implementation by DHHS only met two of ten recommended components of a well-designed pilot program. In addition, the legislative prohibition against using state or Medicaid funding for the pilot hindered its effectiveness. Furthermore, no organization affiliated with respite care maintains data on the need for the service. The General Assembly should allow the pilot program authorizing overnight respite at adult day care facilities to expire on June 1, 2015, and require state agencies and institutions initiating pilot projects to adhere to standards established by UNC's School of Government.

Final Report

Executive Summary

Presentation

Interim Report Mandated by SL 2015-241

Relevant Legislation:

  • House Bill 70/Senate Bill 43 (2017–18): An act to require the School of Government at the University of North Carolina to develop standards for state agencies to use when designing and implementing pilot projects mandated by the General Assembly, to require the Office of State Budget and Management to adopt rules implementing those standards, and to require all pilot projects mandated by the General Assembly to use those standards, as recommended by the Joint Legislative Program Evaluation Oversight Committee. This legislation was not enacted.
  • Session Law 2015-52: An act to extend the duration of the overnight respite pilot program and to provide a more comprehensive evaluation of the pilot program.
  • Session Law 2015-241, Section 12.G3.(a) expands the overnight respite service to adult day care facilities statewide, making it a permanent service, and sets the pilot program to be repealed upon the adoption of licensure rules or in June 2017, whichever is earliest. The legislation also allows these facilities to collect state and Medicaid funding for the service.
  • House Bill 1028/Senate Bill 804 (2015–16): An act to require the School of Government at the University of North Carolina to coordinate a working group charged with developing standards for state agencies to use when designing and implementing pilot projects mandated by the General Assembly, to require the Office of State Budget and Management to adopt rules implementing those standards, to repeal the Program Evaluation Division study of overnight respite services, and to require the Department of Health and Human Services to report on overnight respite services to the Joint Legislative Oversight Committee on Health and Human Services, as recommended by the Joint Legislative Program Evaluation Oversight Committee. This legislation was not enacted.
  • House Bill 72/Senate Bill 91 (2015–16): An act to require the School of Government at the University of North Carolina to coordinate a working group charged with developing standards for state agencies to use when designing and implementing pilot projects mandated by the General Assembly, and to require the Office of State Budget and Management to adopt rules implementing the standards. This legislation was not enacted.

Subsequent Agency Action:

  • PED identified several state-run facilities offering overnight respite at substantially lower rates than nearby adult day care facilities. These state facilities were offering the service for $8 per day of overnight respite care. Since the report’s release, DHHS has increased this daily rate to $40 per day.
  • The final report required by S.L. 2015-52 was submitted by DHHS and accepted by the Joint Legislative Program Evaluation Oversight Committee at its September 12, 2016 meeting.