A BILL TO BE ENTITLED
AN ACT TO EXPAND THE STATE/COUNTY SPECIAL ASSISTANCE IN-HOME DEMONSTRATION PROJECT BY PERMITTING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO INCREASE THE NUMBER OF INDIVIDUALS WHO MAY BE ENROLLED IN THE PROJECT.
The General Assembly of North Carolina enacts:
SECTION 1.(a)  The Department of Health and Human Services may use funds from the existing State/County Special Assistance for Adults budget to provide Special Assistance payments to eligible individuals in in‑home living arrangements. These payments may be made for up to a two‑year period beginning July 1, 2003, and ending June 30, 2005.  The standard monthly payment to individuals enrolled in the Special Assistance demonstration project shall be fifty percent (50%) of the monthly payment the individual would receive if the individual resided in an adult care home and qualified for Special Assistance, except if a lesser payment amount is appropriate for the individual as determined by the local case manager. The Department shall implement Special Assistance in-home eligibility policies and procedures to assure that demonstration project participants are those individuals who need and, but for the demonstration project, would seek placement in an adult care home facility.  The Department shall make this demonstration project available to all counties on a voluntary basis. To the maximum extent possible, the Department shall consider geographic balance in the dispersion of payments to individuals across the State. The Department shall make an interim report to the cochairs of the House of Representatives Appropriations Committee, the cochairs of the House of Representatives Appropriations Subcommittee on Health and Human Services, the cochairs of the Senate Appropriations Committee, and the Chair of the Senate Appropriations Committee on Human Resources by June 30, 2004, and a final report by January 1, 2005.   The final report shall also be sent to the North Carolina Study Commission on Aging. This report shall include the following information:
(1)	A description of cost savings that could occur by allowing individuals eligible for State/County Special Assistance the option of remaining in the home.
(2)	Which activities of daily living or other need criteria are reliable indicators for identifying individuals with the greatest need for income supplements for in‑home living arrangements.
(3)	How much case management is needed and which types of individuals are most in need of case management.
(4)	The geographic location of individuals receiving payments under this section.
(5)	A description of the services purchased with these payments.
(6)	A description of the income levels of individuals who receive payments under this section and the impact on the Medicaid program.
(7)	Findings and recommendations as to the feasibility of continuing or expanding the demonstration program.
(8)	The level and quantity of services (including personal care services) provided to the demonstration project participants compared to the level and quantity of services for residents in adult care homes.
(9)	A fiscal analysis and programmatic results of increasing the demonstration project participant's monthly assistance payment to fifty percent (50%) of the Special Assistance monthly payment.
(10)	A fiscal analysis of the budgetary impact of any increases in staff responsibility resulting from utilization of the Demonstration Program.
SECTION 1.(b)  The Department shall incorporate data collection tools designed to compare quality of life among institutionalized vs. noninstitutionalized populations (i.e. an individual's perception of his or her own health and well-being, years of healthy life, and activity limitations). To the extent national standards are available, the Department shall utilize those standards.
SECTION 1.(c)  The Department shall expand its report of the Demonstration Program in order to fully assess the success of the pilot. The Department shall contract with an independent consultant to develop an evaluation design that ensures that the evaluation includes an assessment of the impact of the Program on the economic security, health, and well-being of the participants.
SECTION 2.  The Department of Health and Human Services shall use funds appropriated to it for the 2003 biennium for the Special Assistance payments authorized in Section 1 of this act.
SECTION 3.  This act becomes effective July 1, 2003.