A BILL TO BE ENTITLED
AN ACT TO PROVIDE THAT THE COUNTY SHARE OF THE NONFEDERAL SHARE OF MEDICAID COSTS for the 2006‑2007 fiscal year SHALL NOT EXCEED THE COUNTY SHARE PAID BY EACH COUNTY FOR THE 2005‑2006 FISCAL YEAR; TO APPROPRIATE FUNDS TO COVER THE COST TO THE GENERAL FUND OF CAPPING THE COUNTY SHARE; and to provide for further reduction in the county share on a targeted basis using savings realized from the medicare part d program.
The General Assembly of North Carolina enacts:
SECTION 1.(a)  Notwithstanding any other provision of law to the contrary, each county's portion of the nonfederal share of Medical Assistance Program costs, excluding administrative costs, for the 2006‑2007 fiscal year shall not exceed the amount paid by the county for the nonfederal share of Medical Assistance Program costs, excluding administrative costs, for the 2005‑2006 fiscal year. It is the intent of the General Assembly to extend the cap on county Medicaid expenditures to the 2007-2008 fiscal year only.
SECTION 1.(b)  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Medical Assistance,  the sum of thirty million three hundred ninety thousand dollars ($30,390,000) for the 2006‑2007 fiscal year to cover the increased cost to the State resulting from the cap on county share required by this section.  These funds shall be allocated from savings realized in the State Medical Assistance program from the Medicare Part D federal program for the 2006‑2007 fiscal year.
SECTION 2.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Medical Assistance, the sum of thirty‑four million six hundred ten thousand dollars ($34,610,000) for the 2006‑2007 fiscal year.  These funds shall be allocated from savings realized from the Medicare Part D federal program for the 2006‑2007 fiscal year. The Department shall allocate these funds to reduce the county share of the nonfederal share of Medical Assistance Program expenditures for the 2006-2007 fiscal year, as follows:
(1)	Forty percent (40%) shall be allocated among counties with a Medicaid eligible population of twenty‑five percent (25%) or greater of the total county population. The allocation shall be based on a county's percentage of the total Medicaid budget for all counties with a Medicaid eligible population of twenty‑five percent (25%) or greater.
(2)	Fifty‑five percent (55%) shall be allocated among counties with a Medicaid eligible population of at least fifteen percent (15%) but less than twenty‑five percent (25%) of the total county population. The allocation shall be based on a county's percentage of the total Medicaid budget for all counties with a Medicaid population of at least fifteen percent (15%) but less than twenty‑five percent (25%).
(3)	Five percent (5%) shall be allocated to counties with a Medicaid population of less than fifteen percent (15%) of the total county population. The allocation shall be based on a county's percentage of the total Medicaid budget for all counties with a Medicaid population of less than fifteen percent (15%).
Funds allocated under this section may be increased to reflect growth in Medicaid expenditures for the 2005-2006 fiscal year.
SECTION 3.1.  There is established the Legislative Study Commission on the Elimination of County Financial Participation in Medicaid Services.
SECTION 3.2.  The Commission shall consist of 14 members appointed as follows:
(1)	Three members appointed by the President Pro Tempore of the Senate. 
(2)	Three members appointed by the Speaker of the House of Representatives. 
(3)	One county commissioner and one county manager appointed by the President Pro Tempore of the Senate upon the recommendation of the North Carolina Association of County Commissioners.
(4)	One county commissioner and one county finance officer appointed by the Speaker of the House of Representatives upon the recommendation of the North Carolina Association of County Commissioners.
(5)	One school board representative appointed by the President Pro Tempore of the Senate upon the recommendation of the North Carolina School Boards Association.
(6)	One municipal representative appointed by the Speaker of the House of Representatives upon the recommendation of the North Carolina League of Municipalities.
(7)	One business representative with public finance experience appointed by the Governor upon the recommendation of the North Carolina Citizens for Business and Industry.
(8)	One representative from the executive branch appointed by the Governor.
The President Pro Tempore of the Senate and the Speaker of the House of Representatives shall each designate a cochair of the Commission from their appointees.
SECTION 3.3.  The Commission shall study and recommend a permanent financing strategy leading to the elimination of county financial participation in Medicaid services.  In conducting the study, the Commission shall consult with the North Carolina Local Government Commission and with the School of Government at the University of North Carolina at Chapel Hill.
SECTION 3.4.  Members of the Commission shall receive subsistence and travel allowances at the rates set forth in G.S. 120‑3.1, 138‑5, or 138‑6, as appropriate. With the prior approval of the Legislative Services Commission, the Legislative Services Officer shall assign professional and clerical staff to assist in the work of the Commission. With the prior approval of the Legislative Services Commission, the Commission may hold its meetings in the State Legislative Building or the Legislative Office Building. The Commission, while in the discharge of its official duties, may exercise all the powers provided under the provisions of G.S. 120‑19 and G.S. 120‑19.1 through G.S. 120‑19.4, including the power to request all officers, agents, agencies, and departments of the State to provide any information, data, or documents within their possession, ascertainable from their records, or otherwise available to them and the power to subpoena witnesses.
SECTION 3.5.  The Commission shall submit a final written report of its findings and recommendations by January 1, 2007.  All reports shall be filed with the President Pro Tempore of the Senate, the Speaker of the House of Representatives, and the Legislative Librarian. Upon filing its final report, the Commission shall terminate.
SECTION 3.6.  From funds appropriated to the General Assembly, the Legislative Services Commission shall allocate funds for the expenses of the Commission established in this Part.
SECTION 4.  This act becomes effective July 1, 2006.