A BILL TO BE ENTITLED
AN ACT TO appropriate funds TO IMPROVE THE MENTAL HEALTH, DEVELOPMENTAL DISABILITIES, AND SUBSTANCE ABUSE SERVICES SYSTEM, AS RECOMMENDED BY THE JOINT LEGISLATIVE OVERSIGHT COMMITTEE ON MENTAL HEALTH, DEVELOPMENTAL DISABILITIES, AND SUBSTANCE ABUSE SERVICES.
The General Assembly of North Carolina enacts:
SECTION 1.  Leadership Academy Funds. – There is appropriated from the General Fund to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the sum of five hundred thousand dollars ($500,000) for the 2009‑2010 fiscal year and the sum of five hundred thousand dollars ($500,000) for the 2010‑2011 fiscal year.  These funds shall be allocated to local management entities (LMEs) for LME staff participation in the Mental Health Leadership Academy at the University of North Carolina Kenan‑Flagler Business School.
SECTION 2.  Child Treatment Program Funds. –  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the sum of two million dollars ($2,000,000) for the 2009‑2010 fiscal year and the sum of two million dollars ($2,000,000) in recurring funds for the 2010‑2011 fiscal year for the North Carolina Child Treatment Program.  The North Carolina Child Treatment Program shall use these funds to provide (i) training and ongoing support to clinicians who provide treatment under the program and (ii) evidence‑based mental health treatment to children and adolescents residing in this State who have experienced serious psychological trauma and their families.
SECTION 3.  Fully Fund Implementation of Tier 1 of CAP/MR‑DD Program. – There is appropriated from the General Fund to the Department of Health and Human Services, Division of Medical Assistance, the sum of three million three hundred thirty‑three thousand three hundred thirty‑three dollars ($3,333,333) for the 2009‑2010 fiscal year and the sum of three million three hundred thirty‑three thousand three hundred thirty‑three dollars ($3,333,333) in recurring funds for the 2010‑2011 fiscal year.  These funds shall be used to fully fund implementation of Tier 1 of the CAP/MR‑DD Program.
SECTION 4.  Housing Initiative Funds to Reduce Long‑term Need for State Psychiatric Hospitals. – There is appropriated from the General Fund to the Housing Trust Fund the sum of ten million dollars ($10,000,000) for the 2009‑2010 fiscal year for the Housing Initiative in order to reduce the need for State psychiatric hospitals in the long term.
SECTION 5.  MH/DD/SA Funds for Housing Initiative Units. – There is appropriated from the General Fund to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the sum of two million five hundred thousand dollars ($2,500,000) for the 2009‑2010 fiscal year and the sum of two million five hundred thousand dollars ($2,500,000) for the 2010‑2011 fiscal year to continue operating support for an estimated 500 units of the Housing Initiative in order to reduce the need for State psychiatric hospitals in the long term.
SECTION 6.  Funds for Regionally Hosted Substance Abuse Services. – Of the funds appropriated to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services for the 2009‑2010 fiscal year for substance abuse services, the Department shall allocate not less than eight million dollars ($8,000,000) and may allocate up to ten million dollars ($10,000,000) for the 2009‑2010 fiscal year to support regionally hosted substance abuse services. These funds shall be allocated to continue or expand Cross Area Service Programs (CASP) and other substance abuse treatment and prevention initiatives.
SECTION 7.  Money‑Follows‑the‑Person Demonstration Grant. –  There is appropriated from the General Fund to the Department of Health and Human Services the sum of one hundred thousand two hundred forty‑seven dollars ($100,247) for the 2009‑2010 fiscal year.  These funds shall be used to supplement a federally supported grant for the transition of consumers out of nursing facilities, State psychiatric hospitals, and Intermediate Care Facilities for the Mentally Retarded (ICF/MR) to more appropriate levels of care.
SECTION 8.  NCIOM Substance Abuse Task Force Recommendations. – There is appropriated from the General Fund to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the sum of ten million dollars ($10,000,000) for the 2009‑2010 fiscal year.  These funds shall be used to implement one or more of the North Carolina Institute of Medicine (NCIOM) Substance Abuse Task Force's priority recommendations, which include:
(1)	Development of a comprehensive substance abuse prevention plan for use at the State and local levels.
(2)	Providing funding for the establishment of six pilot projects to implement county or multicounty comprehensive prevention plans.
(3)	Supporting efforts to reduce high‑risk drinking on college campuses.
(4)	Development of a pilot program to provide chronic disease management services to substance abuse clients and former clients. The purpose of the pilot is to decrease the number of short‑term hospital admissions and to provide discharge planning and follow‑up to reduce substance abuse client recidivism. 
(5)	Educating and encouraging health care professionals to use the screening, brief intervention, and referral to treatment (SBIRT) model promoted by the federal government.
SECTION 9.  Outpatient Commitment Pilot. – There is appropriated from the General Fund to the Department of Health and Human Services the sum of two million two hundred eighty‑six thousand four hundred dollars ($2,286,400) for the 2009‑2010 fiscal year. The Department, consulting with the Administrative Office of the Courts, shall develop a pilot program to test a new process for tracking and providing services to persons in State psychiatric hospitals for whom an outpatient commitment order has been issued.  The pilot should initially focus on individuals in State hospitals where the individual's treatment history is known and should provide for extended outpatient commitment for not less than 180 days.  The pilot shall include arrangements with LMEs as the point of accountability‑tracking and overseeing the individual's services and treatment at all times.  The pilot shall identify a provider willing to accept outpatient commitments that have a history of difficulty in maintaining tracking and treatment of the client.  The pilot shall also arrange for the designation of hospital liaison personnel to assist with discharge planning.  Except for the 180 extended outpatient commitment time, if a conflict arises between this subsection and Part 7 of Article 5 of Chapter 122C of the General Statutes pertaining to outpatient commitments, Part 7 of  Article 5 prevails.
SECTION 10.  Workforce Development Funds. – There is appropriated from the General Fund to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the sum of fifty thousand dollars ($50,000) for the 2009‑2010 fiscal year and the sum of fifty thousand dollars ($50,000) for the 2010‑2011 fiscal year.  These funds shall be used to establish a workforce development specialist position in the Division.
SECTION 11.  Local Crisis Capacity Funding. – There is appropriated from the General Fund to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the sum of twenty‑four million three hundred twenty‑four thousand four hundred thirty‑two dollars ($24,324,432) for the 2009‑2010 fiscal year.  These funds shall be allocated as follows:
(1)	$8,227,932 to fully fund local crisis initiatives that were partially funded in the 2008‑2009 fiscal year, and 
(2)	$16,096,500 to purchase one hundred fifty additional local inpatient psychiatric beds or bed days. 
The one hundred fifty additional beds or bed days funded under subdivision (2) of this subsection shall be distributed across the State according to need as determined by the Department. The Department shall enter into contracts with the LMEs and community hospitals for the management of beds or bed days funded under this subsection. Local inpatient psychiatric beds or bed days shall be managed and controlled by the LME, including the determination of which local or State hospital the individual should be admitted to pursuant to an involuntary commitment order. Funds shall not be allocated to LMEs but shall be held in a statewide reserve at the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services to pay for services authorized by the LMEs and billed by the hospitals through the LMEs. LMEs shall remit claims for payment to the Division within 15 working days of receipt of a clean claim from the hospital and shall pay the hospital within 10 working days of receipt of payment from the Division. If the Department determines (i) that an LME is not effectively managing the beds or bed days for which it has responsibility, as evidenced by beds or bed days in the local hospital not being utilized while demand for services at the State psychiatric hospitals has not reduced, or (ii) the LME has failed to comply with the prompt payment provisions of this subsection, the Department may contract with another LME to manage the beds or bed days, or, notwithstanding any other provision of law to the contrary, may pay the hospital directly. The Department shall develop reporting requirements for LMEs regarding the utilization of the beds or bed days. Funds appropriated in this section for the purchase of local inpatient psychiatric beds or bed days shall be used to purchase additional beds or bed days not currently funded by or through LMEs and shall not be used to supplant other funds available or otherwise appropriated for the purchase of psychiatric inpatient services under contract with community hospitals, including beds or bed days being purchased through Hospital Pilot funds appropriated in S.L. 2007‑323. Not later than March 1, 2010, the Department shall report to the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, and the Fiscal Research Division on a uniform system for beds or bed days purchased (i) with local funds, (ii) from existing State appropriations, (iii) under the Hospital Utilization Pilot, and (iv) purchased using funds appropriated under this subsection.
SECTION 12.  BART Step‑Down Unit Funds. – There is appropriated from the General Fund to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the sum of one million eight hundred thousand dollars ($1,800,000) for the 2009‑2010 fiscal year and the sum of three hundred thousand dollars ($300,000) for the 2010‑2011 fiscal year. These funds shall be used to develop a behaviorally advanced residential treatment (BART) step‑down unit that would be operated by the Murdoch Center.  These funds include private provider training and technical assistance to facilitate replication through the State.
SECTION 13.  Funds to Increase Staffing and Salary Ranges at DHHS and the State Psychiatric Hospitals. – There is appropriated from the General Fund to the Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, the sum of five hundred thousand dollars ($500,000) for the 2009‑2010 fiscal year and the sum of five hundred thousand dollars ($500,000) for the 2010‑2011 fiscal year. These funds shall be used to increase staff and raise salary ranges for Division and State psychiatric hospital personnel.
SECTION 14.  This act becomes effective July 1, 2009.